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Table of Contents
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 Corneal tear, Ellen - Mandeville, IA, 1/17/2001
  How big a piece, William B. Trattler, MD Miami, FL 1/21/2001, (#1)
 Flap, dee - malden, MA, 9/06/2002, (#2)
Flap tear, dee - malden, MA, 9/06/2002, (#3)
answer, William B. Trattler, MD Miami, FL 9/07/2002, (#4)
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"Corneal tear"
Posted by Ellen - Mandeville, IA on 18:39:08 1/17/2001
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During Lasik surgery, the doctor tore a piece of my cornea off with tweezers. I am concerned about permanent damage. Any information would be appreciated.
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1. "How big a piece"
Posted by William B. Trattler, MD on 11:37:41 1/21/2001
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This is a difficult question to answer - how big of a piece, and where was it located. A small piece that tore off in the peripheral cornea may have no effect - but I just have no idea of what exactly happenned and how much cornea is missing.
I am sorry I can not help further
Bill Trattler,MD
Miami, FL
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2. "Flap"
Posted by dee - malden, MA on 12:45:20 9/06/2002
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My doctor tore 1/4 of my flap off during an epithelial cleaning and this caused me to have my whole flap amputated. I now have what appears to be long term or permanent mutiple vision because of steep astigmatism. I think the doctor was not careful enough when he tried to lift my flap and this has caused misery in my life. The doctor should be able to lift the flap without tearing it if he is a good skilled surgeon my common sense tell me - or he shouldn't lift it at all.
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3. "Flap tear"
Posted by dee - malden, MA on 12:46:40 9/06/2002
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Do you consider this tear or rip to be malpractice?
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4. "answer"
Posted by William B. Trattler, MD on 08:12:02 9/07/2002
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Lifting a flap is not risk-free. LASIK is a real surgery, and additional surgery to fix problems following LASIK come with risk.
LASIK flaps are not always of uniform thickness. It is certainly possible that you had a thin area of your flap, or even the epithelial ingrowth could have caused some mild melting of the flap which made it more susceptible to being injured during the procedure. As you may know - occasionally epithelial ingrowth will cause melting of a flap - so that the flap first starts to thin, and then is digested by enzymes from the epithelial ingrowth.
If the flap was of normal strength, it would be very difficult to tear/rip. So there must have been some problem with the flap, which is why the doctor had recommended that the flap be lifted.
As for your current situation - one can consider superficial laser to smooth out the anterior corneal surface and remove any scar tissue. As well, we expect that custom (wavefront) LASIK will be effective in helping patients with irregular astigmatism.
I hope this helps
Bill Trattler, MD
Miami, FL
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