My LASIK surgery was last friday (Sept 10th) and here's my situation: the procedure on my right eye went fine and I am happy with the results. On the left eye, after the treatment the doctor said the flap was cut too thin for his liking (he says it was a keratome problem) and he immediately put in a bandage contact and took me to the slit lamp for a closer look. It looked ok immediately and 24 hrs post op (wore contacts in both eyes for the first 24 hrs). In the next three days the vision in the left eye got progressivly worse (from 20/50 to about 20/80). Four days post op (yesterday), I was examined again and found to have small wrinkles in the left (thin) flap. He does not want to relift for fear of causing damage to the thin flap. He believes it is best to be patient and not do anything rash. He made an appointment for me to see another doctor for a second opinion (in six days) and as of now he thinks something like topolink may be my best bet.
My questions are: Do you agree that it's better to be patient?; would VISX CAP be a better solution?;
any other comments/observations?

For people with striae in their flap - it is a general rule of thumb that the soone they are removed, the better. Of course, if there is another problem with the flap, the patient would need to be carefully examined. The risks of lifting the flap must be weighed against the potential benefit of removing the striae.
In general, it would be best to have an evaluation ASAP and not wait an extra week. You of course need to talk with your own doctor about what course would be best
Just a note - the CAP program with the VISX is for irregular astigmatism - and is not for removing flap striae

Bill Trattler, MD
Miami, FL

once again, i agree whole heartedly with dr trattler's comments. it is very difficult to give an opinion without seeing the flap myself. i would tend to refloat the flap early. getting a second opinion is your most important step.

my friend ed manche is at stanford university, and would be a great md to look at your eye.

debra tennen, md

Thank you Drs Tratler and Tennen for your replies.
After further discussion with my Dr I learned that my flap is actually kind of quasi-buttonhole. The reason he does not want to touch it right now is that he is afraid it may rupture and become a full blown buttonhole. He had consulted with Dr Manche (who I will see this coming monday) and another LASIK doc who at this point agree with the strategy.

(the computer lost the rest of my response!!?)

Given the additional information in the above post, does this strategy make sense? (it does to me, but I'm not a LASIK doc and want to get as many opinions as possible!)

Thanks again for your advice

joel,

it sounds like your doctor is handling things appropriately. in the threemonths, the swelling of the flap may subside such that there is only a small refractive error remaining. at that time, another flap may be created and the laser used to correct the vision.

in the meantime, go for the second opinions, and use spectacles if you need to.

say hello to ed manche if you get to him!
debra tennen, md