I had LASIK on 5/10. My vision prior was 20/80 (left) and 20/100 (right). I found out during the procedure that I have very small eye sockets and placement of the speculum was very difficult - this was very uncomfortable for me! The next day, I had my right flap relifted twice for "cells under the flap" and then for a wrinkle. On the 2nd post op day, everything looked fine and my vision was 20/20 (left) and 20/25 (right). The real problem started at my one week visit when he said that I have small striae in the middle of my right flap. He did not want to relift it that day for a couple of reasons: 1. he said they are very small 2. they are not affecting my vision very much (20/25-30 in that eye) 3. I was a difficult case (small sockets) 4. he was going out of town the next day for 10 days and did not want to do anything like that and then leave 5. he said that it was his experience that striae like these, if left alone, would not get worse, but would either stay the same or improve. I will see him again at 3 weeks post-op (6/2) so that he can recheck that flap and make a decision about relifting it.
My question(s) is: does his reason for not relifting it make any sense? Should I leave them there if my vision is no worse and if the striae are not worse? What problems can occur in the future if striae are left on the cornea?
sorry for the long message, but I am frustrated!!

Striae are basically tiny folds in the flap. Striae can cause distortion of vision (some people might call it irregular astigmatism). Striae are basically a sign that the flap is not perfectly aligned (like if your carpet at home had a fold in it, you would need to stretch your carpet and reposition it to remove the fold).
The question is - is the flap imperfection afecting your vision? The reason this is important is because many tiny folds (striae) do not affect vision - so in these situations the risks of lifting the flap and trying to remove the striae would potentially outweigh the benefit of asymptomatic striae.
However, if the striae are affecting your vision, then the goal is to remove striae early rather than late (late means months).
Of course - straight uncorrected visual acuity does not tell you how the striae affect your vision, as many people will generally have some mild refractive error. Therefore - you need to have your refraction carefully measured and find out your quality of vision with "correction" to determine the effect of the striae

I hope this helps

Bill Trattler, MD
Miami, FL