I´ve had my Lasik surgery 4 and a half months ago, and developed striae on both my eyes, which causes me a frustrating multiple vision.
I became suspicious of this problem through the questions posted at asklasikdocs, looking at the answers to people with similar sympthoms than mine, and the answer Dr. Trattler gave to my own question, for during more than 3 months the ophtalmologyst who performed my surgery kept telling me “..your eyes are perfect, you just have to wait”
Last week I visited the fourth ophtalmologyst who confirmed the existence of the striae.
He proposed me to act immediately to try to flatten the flaps, though he warned me of the difficulty of this after more than 4 months post-op.
He also told me that if I used RGP contact lenses, my vision would also improve.
I seems I have to make a decision on which route to take, and I would like to have some advice on this matter.

My specific questions are:

- What are the chances of succeeding in an attempt to remove striae 4 months post-op? Is it worth the trial?

- This ophtalmologyst told me that if one surgery is not enough to remove all striae, he can relift the flap again and again until the flap remains flat. Besides infection, is there any additional risk on relifting the flap several times?

- In the case that I tried with the RGP´s and I found that they don´t solve the problem, can I try the surgical procedure later? (I ask this because one of the ophtalmologyst told me that if I put on an RGP this would cause the striae to become more fixed and impossible to resolve)

- Supposing the RGP solve the problem, is there any risk in living forever with the striae?

Thank you very much for your time, I´d highly appreciate your comments, couse I have to take the decision soon. Thank you again, if it hadn’t been for this site perhaps I would still be believing that my eyes are perfect and only need to wait.

For patients with striae present for many months, it is often very difficult to remove the striae. The reason is - that the striae have developed a memory - so that after the flap is lifted and smoothed - the striae will often just come right back.
The one procedure that seems to work best for patients with long-term striae is flap suturing. Dr. Mark Speaker in Manhattan reported his success with suturing flaps in patients with long-term striae (his series is of 26 patients). I have experience with 2 cases of flap suturing after multiple failed attempts at striae removal - and in both cases the striae resolved by the next day.
If your doctor has any questions about flap suturing, I would be more than happy to help answr questions regarding this.

As for your question about multiple surgeries - the biggest risks include infection, inflammation, epithelial ingrowth, corneal abrasions, etc (please ask your doctor for the complete list of risks). These risks are generally the same level with each procedure.

Best of luck

Bill Trattler, MD
Miami, FL
ext 1200

Thanks, Dr. Trattler.

Last week I went through an attempt to smooth the flap on my left eye. The surgeon provoked a flap edema by means of a saline solution.

Surgeon says that it was rather succesful because some folds dissapeared, but the most important, which were right in the line of vision did not, so my vision didn't improve at all (in fact, it's rather worse than before).

In three weeks he plans to do a second attempt.

He told me about the option of suturing the flap, and I'm quite concerned about this.

Are the risk of infection increased when suturing the flap?
Which are the side effects that suturing the flap could imply? Given that this way wrinkles are resolved, is it likely that another problem will appear instead of the wrinkles due to the suturing?
Does an edema cause a damage to the flap?
Should I try with an RGP to see if it corrects my vision and not have my eye touched anymore?
I have the fear that two or three edemas and then the flap suturing will cause a permanent damage to the flap, so even when at last the folds are resolved the damage caused will make me have a vision as bad as now.

I would like to hear experiences from people who has been in this situation of trying to resolve flap folds after several months.

Thank you very much for your time.

Gabriel