Flap Complications FAQ
Please select your question from the following list of FAQs:
How is the flap created during LASIK?
The microkeratome is the machine that makes the flap for LASIK. The machine works by first creating suction against the eye, which holds the machine in the correct machine and firms the eye for a precise cut. Then the surgeon will engage the machine, allowing it to cut a smooth flap in the cornea. However, there are a variety of uncommon situations that can occur when making the flap
What is the significance of a short flap?
A short or incomplete flap occurs when the microkeratome can not complete its pass. The flap is too short, resulting in insufficient room for the laser treatment to be performed. In this situation, the general rule is to wait 3 months and at that point repear the surgery anc create a new flap. The second procedure is very safe, although there is a slight increased risk of having a flap problem compared to an eye that has not had a short flap.
What is the significance of a free flap?
A free flap or cap can also occur, and is probably slightly more common than other flap situations. This was actually the method used in the 1970ís and 1980ís when a mechanical form of myopic correction was performed (called ALK). Since most surgeons mark the cornea with ink prior to surgery, it is relatively straight forward to realign the cap. Depending on the situation, some surgeons will perform the laser treatment and then replace the cap, while other surgeons may abort the laser portion of the surgery. In general, the visual results with this situation should be similar to LASIK with a normal flap
What is the significance of a buttonhole flap?
A button hole is the name given to the situation in which the flap is thin and there is an actual hole in the flap. People with very steep corneas are at higher risk of a buttonhole than a patient with flatter cornea (prior to surgery). When a buttonhole occurs, most surgeons will not continue with the laser, and instead carefully replace the flap. If the flap heals well and there is no scarring, it is possible to retreat the eye months later with either LASIK or PRK. However, there is a risk of scarring at the site of the buttonhole, which can lead to some decreased vision. Therefore, close followup with the surgeon is crucial to providing the best visual recovery.
What is the significance of flap wrinkles?
Flap wrinkles (striae): Folds in the flap after LASIK are called flap wrinkles or flap striae. Wrinkles fortunately are not very common, but they can cause decreased vision as well as contribute to night-time halos or starbursts. Wrinkles can generally be reduced or eliminated during the first few days after LASIK by lifting and repositioning the flap. Flap wrinkles that have remained in place for months or longer may be difficult to fix. However, these wrinkles in the flap can sometimes be lessened or removed even months after surgery.