I'll do my best to make a long story short. I had custom LASIK in both eyes about 8 months ago. Within 1 week after the surgery, I noticed double vision in both eyes (although it was significantly worse in the right eye) approx 3.5 months after the initial surgery, the surgeon attempted to "massage" the flaps in order to try and remove striae from both eyes. This was sucessful in the left eye but not the right. The vision in the left eye did not chance after the striae were removed. The vision in the right eye actually became significantly worse.

Shortly afterward, the surgeon re-lifted, stretched, heated, and replaced the right-eye flap. The net result of this is that the right eye striae were "reduced"...but the vision still has significant glare and loss of contrast when compared to the left eye. Also, there was a great deal of swelling in the right eye after the re-lift...making the eye highly myopic immediately after the procedure.

It is now approx 2 months ince the relift. The muopia has reduced...but not completely gone away in the right eye. There are still striae present. BCSA is about 20/40 in the right eye, and UCVA is worse (because of the myopia)...but I'm not 100% sure what it is.

My original surgeon is recommending sutures in the flap to try and help remove the chronic striae at this point.

I just received a second opinion from another surgeon. He does not think that the striae can be removed with sutures, and he would like to try a combined PRK/PTK approach.

I'm lost...what do I do? Which one is right? I did find an article online where striae 2 years old were removed with sutures.....is the second doctor wrong...should I try sutures first?

Thanks in advance for any advise you can give.

I have found the flap striae can be effectively reduced with both flap sutures and laser. In other words - both doctors are correct in what they are recommending. Both procedures would be expected to reduce your degree of striae.
Here are my thoughts. As you are aware - the reason you have striae is because the flap did not settle in the proper position. So it would make more sense theoretically to lift the flap and then place sutures - so that the flap would return to its normal shape. This is a very straightforward procedure. Your vision would be blurry for a few weeks while the sutures are in place, but then once they are removed, your striae should be gone, and then one would expect you would have improved vision.
If flap suturing failed, then you could always go to superficial laser treatment.

I hope this helps

Bill Trattler, MD
Miami, FL