I am six weeks post LASIK and am having some difficulty with my left eye (right is perfect). My pre-op for this eye was a –8.5 (right was -6.25) and have been diagnosed with flap microstriae just above and below the pupil.

My doctor, a recognized expert in this area, performed a smoothing procedure (in the slit-lamp chair) the day after surgery and again 1-week post-op with what appeared to be a cotton swab. My current vision in this eye fluctuates between 20/25 and 20/30 and I see a vertical glare/halo on the top of all light (and especially white) objects. I also see V-shaped vertically-oriented starbursts in lights at night. Immediately after applying Thera-tears drops, my vision clears up, only to return when the apparent smoothing effect of the liquid diminishes.

My doctor is recommending a flap lift, stretch, and suturing to remove the wrinkles. Is there any data (statistical or otherwise) on the results of this procedure? My concern is that I will be left with an irregular astigmatism and/or that my refraction will change for the worse.

Should I suggest that the procedure be carried out without suturing and recommend that a bandage contact lens be used instead?

Can an enhancement be performed on a previously sutured flap?

Any comments will be greatly appreciated!

Thanks - Tony

There are a number of ways that striae can be treated all with equal results and I would go with the procedure that your doctor is most comfortable with and feels is the most effective in his hands. I treat straie with a combination of lift and smooth as well as "ironing" with a special instrument, it has worked the best for me. I don't particularly like suturing but I know doctors that rely on sutures for difficult striae and works great. Any type of striae management can reduce or eliminate striae, but all can induce irregular astigmatism if not done enough or done too much. I don't know of any formal scientific results, just that there are "different strokes for different folks". This is a case where if your doctor is an "expert" to trust what he recommends.

Good luck

Patrick Chin, MD
Westwood, NJ

Suturing the flap can cause astigmatism. Lifting the flap and refloating with Hypertonic saline i.e.4cc of BSS mixed with 1cc of distilled water. This causes edema of flap and flap stretches and wrinkles can be eliminated. You can consult your doctor and discuss this and if you find so you can contact me at