It seems that the most suggested treatment for striae is a refloat. What to do after that fails is now my question.

Would you advise me on any experiences/techniques that you may know of that pertain to flap wrinkles that are more persistent than "normal" or "micro" striae.

At two weeks post-op the doctor did a refloat. Both eyes still have striae affecting visual acuity. The left eye can be corrected to clear 20/30 with a lens. The right can only be corrected to a fuzzy 20-50 to 20-40ish with a lens. My doctor feels that a scrape of the epithelial cells MAY help. He is reluctant to perform this procedure due to the risk that it may not correct the striae. Have you had personal success with removal of the epithelial call as a treatment of striae? I do not want to undergo this until I have exhausted all possible sources for any information to alternate treatment plans. Any suggestions on an approach to a treatment plan would be very much appreciated.

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Striae are basically tiny wrinkles in the flap. Large wrinkles in thge flap are called folds. The treatment of striae and folds is basically to refloat the flap, stretch the flap, and of course remove the striae or folds.
There are many variations to the procedure to remove folds/striae. Perhaps one of the more popular methods is to remove the surface cells (called the epithelium) since is it believed that the striae are locked in by the epithelium. After the epithelium is removed, some doctors may also use hypotonic saline to make the flap swell, and hopefully make the striae disappear.
The removal of striae and folds is not straight forward, so it is important to see a LASIK surgeon who is experienced in striae management. It is critical to remove striae sooner rather than later, because most specialists feel that the striae become more difficult to remove with time.
Please feel free to ask a followup question

Bill Trattler, MD
Miami, FL