At my 1 week appt. after my recent LASIK surgery, my doctor told me I had wrinkles in the flaps of both eyes. He set up an appt for the following day and performed a refloat on both of my eyes. He put contacts on them which he took off the following day. A week later, he once again examined my eyes a told me that I still had striae that was effecting my vision and recommended refloating my flaps once again which we did. (again with contacts for extra insurance) I go back in a week to be examined again but my vision seems similar to what it was after the first refloat. My fear is that I'll have to do it yet again.

I was told that it is rare to have to refloat flaps and very rare that you whould have to do it twice (on the up side all the staff now know me by my first name)

My question is this, what causes striae in the flaps of some folks' eyes but not others? I have been very cautious about not touching them, using my prescribed drops ete. Is there anything I can do to help my chances of not getting them? How many times can a flap be refloated? What are the potential problems (if any) in refloating a flap over and over? Thanks.

Excellent questions, although they are a little difficult to answer. First, Striae are basically wrinkles in the flap. LASIK surgeons aim to keep the flap smooth throughout the procedure and carefully brush out any striae when the flap is replaced after the laser is used. However, some people will get striae and the exact reason that some people get them and other people do not is unknown. If a surgeon sees significant striae that are interfering with vision, then the eye surgeon may elect to refloat the flap. Occasionally, the striae can persist, so that a second float of the flap is needed.

I hope I have covered all of your questions

Best of luck

Bill Trattler, MD
Miami, FL

I've heard a couple of explanations for wrinkles/striae. One is that the higher your myopia, the more ablation occurs, so the more settling down the flap has to do. As it has less surface to lay over now, it is too big, and wrinkles up. It's also been explained this way--you cut a doorway into a rubber wall, make the doorway smaller and then try to fit the door back into it. The door gives under the pressure, and buckles.

I had a pretty severe case of Sands of Sahara, and it can apparently cause "mud cracks" in the flap.
The day after surgery, I had wrinkles in both eyes. My wrinkles disappeared in my good eye, and persist in the SOS eye, even after a relift. It's been four months since my original surgery and two since the relift. My vision in the eye that still has wrinkling is horrible, and I'm going to start getting 2nd opinions on having it relifted again. I found out a couple of days ago that an RGP contact lens will eliminate the effects of the wrinkling--double vision and ghosts. And I do have both--two strong images, plus lots of ghosts around them.

What's an RGP contact lens?

RGP stands for "rigid gas permiable" contact lens (similar to a "hard" contact lens).