I had LASIK performed on 6/15. On 6/21 my doctor confirmed that I had micro striae on my left cornea and the next day performed a procedure to attempt to remove them. (I kept a lens on my eye until the following Monday.) Unfortunately the procedure did not work and now my doctor wants to perform another procedure to remove more of the epitheal layer which he says is what holds the folds in place. I went to another doctor this week for a second opinion and this doctor told me that he wants to use sutures in my eyes to remove the striae because he has not had success with the other methods. I then spoke to another doctor on the phone who was not even familiar with the suturing process as a means to remove striae and would instead use 50% hypertonic solution on the eye for 2 minutes. Understandably, I am extremely confused as well as anxious since more and more time is passing by since the original LASIK procedure. Does anyone have any suggestions as to what I should do or information about suturing? Also, what are the chances that the striae will be removed? Thank you for you help.

Emily

There are many ways to treat striae, and each have their advantages and disadvantages. I will mention the choices, but remember that each doctor may feel more comfortable or confident with certain techniques.
Please let me know if you need a name for a person who is experienced in treating people who develop complications.
The first treatment is simple and straight forward. The flap is lifted, and then reflaoted back into place. A soft murocel sponge (wet) is used to stroke the flap and remove any flap wrinkles. This technique works best in situations where the flap has "slipped" a little out of place.
A second option is to remove the surface layer (called the epithelium) and use hypotonic sterile saline - which will hydrate the flap. The theory is that the epithelium locks in the striae, so swelling the flap causes any microattachments to break, and removing the epithelium helps so that the ubderlying surface can stretch out without being "locked up" by the epithelium.
Another option is to combine the first two techniques - first scrape the epithelium and hydrate the flap, and then lift the flap and reposition it - with lots of stretching and flattening of the flap.
Another method is flap suturing. For severe flap striae or flap striae that have not responded to the above treatments, sutures can be placed to stretch the flap and eliminate the striae. My partner had a patient who was very near-sighted (over 12 diopters) and eneded up with flap striae. Over 3 months, he had a number of procedures with hydration of the flap and strething of the flap - but the striae remained. So I helped him suture the flap - we put in 7 sutures, and the striae had vanished by the next morning - it can be a dramatic improvement.

So this is the general information. Please feel free to email me if you would like me to recommend someone for another opinion

Bill Trattler, MD
Miami, FL

Dr. Trattler,

Thank you for your response. Just to update you, I saw a third doctor who thinks that I should wait for my eyes to heal a little longer before making a decision about whether or not I need more surgery. I have an appointment with him in 6 weeks. I also have an appointment with a 4th doctor in 3 weeks. Obviously, this makes my decision making process even more difficult. Just out of curiosity, who would you refer me to in New York City (or Philadelphia)? Also, do you have any input regarding the most current opinion? Thank you.

Emily

Emily,
Did you decide to go ahead with this procedure? I also had surgery in your area and the surgeon wants me to consider having it done. Would you e-mail me at
Best wishes,
dawnmarie

Dawnmarie,
What does your doctor want you to have done? Sutures? I haven't done anything yet because I am still in the process of doing research and getting more opinions. I will decide what I am going to do by the end of the summer but I am leaning against the suturing procedures. What is your story and who is your doctor?

Emily