After having lasik in both eyes, I returned to the doctor the next day for standard checkup and dicovered wrinkles in left eye, went back to hospital that day and the doctor tried to smooth wrinkles out. After 3.5 weeks, vision has been measured at 20/40, due to striae in center of pupil, vertical in nature. Is another relaying of flap a good idea, is it too late, are there any drops available that may improve my condiotion. My doctor has adopted a wait and see procedure, and is talking about a torq contact as a temporarily fix/remedy. What are my options in your opinion?

Please keep in mind that I haven't actually examined you, so most of this is just speculation....But at this point, Bernie, I'm not so sure that you'll see too much more spontaneous improvement.
After the first flap adjustment, sometimes so fine wrinkles may persist, but those will often improve slightly over time. When there are still major wrinkles, especially centrally, that affect the "best corrected" vision, then I usually will lift the flap again.
Obviously, the more time that passes, the more difficult "ironing out the flap" becomes, but some docs have documented successes several months after the initial surgery.
Lifting the flap does have some risks, including epithelial ingrowth, but this risk is pretty small in the hands of a careful, experienced surgeon.

Your best approach is to check in again with your doc and see what he wants to do. If he is unsure, or if you are uncomfortable with his approach, then you should request a second opinion (or even seek one out yourself). Two heads are better than one, you know.

Good Luck, Dean Hu

the doctor decided to place a hard contact in to allow me to see clearly. While I am relieved that I have correctable vision with the contact, I am interested in options that do include the use of contacts. He said the contact has a smooth outer surface, as opposed to my cornea, due to the wrinkles. Is this going to help the wrinkles or just improve my vision? Should I be thrilled that I can see and never consider laser surgery again?

The hard contact tends to neutralize any corneal irregularities that may exist, but it is unlikely to result in any significant smoothing of your cornea.

So yes, Bernie, be thrilled that you can see again. Currently you have a decent situation; it could be better; it could be worse. But whether it is worth the risk to re-smooth the flap is up to you and your doctor.

Good Luck, Dean Hu

Well, the contact is very irritating, and i wonder if my vision will get better on it's own, or if i should realize that the level I have now is probably it, also, could this new visx CAP i read about smooth the outside of my cornea, and would this be less risky than to relift the flap?

You have described a situation in which you have developed wrinkles in your flap that persist, causing decreased vision. You have stated that your vision improves with a rigid contact lens. However, the contact lens is irritating.
There are many options for you. First, you can consider another lift of the flap with hydration of the flap. This will cause the flap to swell and hopefully remove or reduce the wrinkles in your flap. You can also elect to not have anything done. Your vision may improve spontaneously, but it also may not improve on its own. You should continue to work with your doctor and determine your best course of action. If you are unsure, you may want to consider a second opinon from a LASIK expert. as Dr. Hu stated, sometimes 2 heads are better than 1.

Best of luck

Bill Trattler, MD
Miami, FL

Your problem appears to be in the flap, so straightening out the flap would be a solution.
The Visx CAP software (if we ever see it) is to smooth out irregularities that would be present underneath the flap, so this would not likely be a solution for you.

Bernie
It sound like you have a similar problem that i had. I had a flap complication that resulted in the cornea not being smooth which resulted in the distorted vision. I too tried the contact lens route,but was unable to achieve an acceptable correction. I got to expert opinions, one form Dr. Lee Nordan in San Diego, and one from Dr. Ed Manche at Stanford. They both recommended a lamaller keroplasty, which i had in November. I am still healing at this time. I would continue with the contact lens until you feel completely comfortable with another surgery.

Dear Barb,

Please tell me more about your latest procedure! You can e-mail me at if you'd prefer. I think my surgeon is considering the same route.

Elizabeth

Visited the doctor today, fri. 1-07, said vision is now at 20/30, also did topography scan of left eye, was all same color in center portion of eye, believe this is good, however, still 20/30, but grqadually improving. Dr. is now dead set against relifting the flap. I think this is good, however, does topography scan mean anything in regards to wrinkles?

Topography can not pick up wrinkles.

Bill Trattler, MD
Miami, FL

Doctors,

How frequently (if ever) do you see striae go away on their own, over time? My flap has been relifted, and my surgeon stretched it out. Things are improving, but my ghosts are so bad that my vision is more or less double outside during the day, and I see at least five images in dim light. Some of the ghosts are faint, but a couple of them are very pronounced. I am prepared to give it time and see what happens, but I have questions in the meantime.

If the striae don't go away, how do you determine whether a lamellar graft is needed, or a corneal transplant?

Thanks,
Elizabeth