I have a few questions about refloating the flaps. I was told about 2 weeks after my LASIK (1/22/02) that I had wrinkles in both eyes. I knew something was wrong because headlights had these big giant streaks coming out of them. I asked my surgeon and he told me the starbursts would go away. I got another opinion and think I'm in the right hands now. I had the right eye refloated on 2/8/02 with good results. But I've had a few problems I wanted to ask about before doing the other one.

1. Since doing the refloat, I've noticed ghosting out of that eye. I know I have mild astigmatism in that eye - it was not corrected during the LASIK as discussed with my doctor. I never noticed it until I did the refloat and I'm wondering if that could have caused the shadowing.

2. My near vision in that eye is also not great although I read 20/20 on the eye chart. I did have a pair of glasses made to correct for the astigmatism and they help. I hardly notice it when I'm using both eyes. It's just that I've been testing the right eye a lot since the refloat since I'll have to rely on that one when I do the left eye. Can I expect the near vision to get better as more time goes on?

3. I've also noticed when I put drops in the near vision is great and the shadows are negligible. I do have plugs in the lower lids and they help but I've heard that drops artificially improve your vision for a few moments and that it masks irregular cornea surface, giving good vision. Is this true?

4. Finally because of the problems I've had in the right eye (maybe they've been there since the LASIK but I doubt it), I'm scared about doing the refloat in the non-dominant left eye. My vision in that eye is a solid 20/20 but I still have significant streaks around headlights at night. Is it worth the risk of a refloat, recognizing I'll probably need sutures. Could the sutures result in irregular astigmatism?

5. Finally, what are the risks of not correcting wrinkles for the long-term? What about as my cornea changes as I age?

My surgeon is not pressuring me about the other eye; his feeling is that I need to be comfortable with the right eye first. He has stressed the importance of doing them early as possible but has successfully treated several patients after 3 months or more.

Anyway, I'm obviously really scared about all this. I would just like an objective opinion from one of the doctors. My original prescription was -1.50 and -1.75 and my pupils measured less than 5 at 3 different doctors. Finally I never had a dry eye problem before LASIK that I'm aware of. Any advice?

This is a tough situation - since you have some mild changes that may or may not be due to residual flap striae. The key is for your doctor to perform a careful refraction and to give you glasses with this prescription. If by wearing the prescription all of your symptoms go away - then you would know that these symptoms are due to residual refractive error - not flap striae.
The main problem with flap striae is that the flap has memory - so the longer the flap striae stay - the more difficult they are to remove. You are already at 6-8 weeks - so most people would say that flap striae can be removed at this date - but the results are less than if the striae had been removed shortly after surgery.

I hope this helps - and best of luck

You should also consider a few opinions.

best of luck

Bill Trattler, MD
Miami, FL

Since the refloat, I have noticed ghosting in that eye. It's not too bad close up but is worse for lights at a distance. Is it possible the refloat (scraping and debridement) could have caused this and it's still just healing? It's been about 6 weeks.

My topography shows no irregular astigmatism and there are no wrinkles left in that eye. The eye doesn't look dry to the doctor but my TBUT is still at 6 seconds. Is it possible the dryness is causing the ghosting? I'm just looking for some reassurance that there is still a chance this could heal.

Thanks for your input.