I am a 41 year old family physician and had lasik performed 6 mo ago. My 45 year old sister, unfortunately, had O.U. lasik on Jan 4, 2000 and has distorted vision secondary to complications from stiae. She was initially -12.5 O.D. and -11.5 O.S. She is now +.75 O.U. and seeing about 20/70 O.U. Her surgeon in Lincoln, NE has suggested lifting the flaps now and using a hypotonic solution in hopes of getting a smoother flap. Is this a reasonable approach? What are her options at this point? Are the development of striae a "surgeon dependent" phenomenon? Should I suggest to her that she be seen at a research center or eye institute (I am most familiar with Phillips in Minneapolis as I trained in the area)? U would appreciate any insight you might have for my sister's sake. Thanks!

Striae are tiny folds in the flap, and are due to the flap not settling in the correct position. This is not necessarily surgeon dependent, as patients can have a perfect procedure and have no folds 30 minutes after LASIK, yet the next day can return with a slight flap slippage and striae. Striae occur more commonly in patients with higher levels of myopia, as the corneal removal is larger (so the flap has a bigger gap to fill)
The treatment of striae can be successful, but there are currently many theories and approaches. Common steps/procedures for this include refloating the flap and smoothing the flap with instruments, using hypotonic fluid to make the flap swell, and removal of the surface cells (epithelium) which can allow the striae to resolve more easily.
Universities are not necessarily better places for striae management. Experience with flap management is really the key, regardless of where the doctor is located.

I hope this helps

Bill Trattler, MD
Miami, FL

thomas, i am not a doctor but had lasik and developed striae about 1 week post-op, which i was later told this never happens and usually occurs during the immediate post-op period, anyways, i had my flap repositioned 1 month post-op where my surgeon used a hypotonic solution to cause my cornea to swell, lifted the flap and then repositioned the flap. i again developed striae a few weeks after that but they have since worked themselves out on their own. i have a wonderful doctor and know this was not a result of his performance, if you would like to email me i could give you his name and you could look him up on the internet. he's a cornea specialist and was named the best ophthamologist in america. if you would like more into you can email me at . best of luck to your sister. sincerely yours, lisa