BACKGROUND: Several complications may occur after Lasik surgery, some of which can lead to corneal scarring and irreversible visual loss. We report such a case, with a clinicopathologic correlation. HISTORY AND SIGNS: A forty-seven-year-old patient with a - 6 D myopia had a Lasik performed with a 160 micron Moria microkeratome. This was complicated by the occurrence of a free cap which was sutured 3 times and of an epithelial ingrowth which was scraped. THERAPY AND OUTCOME: A superficial lamellar graft was performed 1S year later because of persistent photophobia and discomfort. Three weeks later the patient had a clear graft and was symptom free. Light microscopy showed an epithelial ingrowth, peripheral breaks and folds of Bowman's membrane, peripheral folds of superficial stroma with fibrosis and compensatory corneal epithelium acanthosis. There is keratolysis of the central stroma. By electron microscopy, the disrupted stroma showed activated fibroblasts, and the superficial epithelium is immature. Pathogenesis of these complications is discussed. CONCLUSIONS: The patient's clinical symptoms are to a certain extent explained by the histopathological findings. Epithelial ingrowth must be treated in time to avoid keratolysis.