Refractive Surgery Week - Flap Striae in LASIK.

3. Flap Striae post LASIK!

• Small wrinkles or folds in the cornea which is common post LASIK surgery.

• Usually asymptomatic but can produce significant visual complaints when the folds are large or involve the visual axis.

•MICROSTRIAE: microscopic, superficial wrinkles that are generally asymptomatic and often only detectable on microscopic examination of the cornea. Involve Bowman’s layer and/or the corneal epithelial basement membrane.

•MACROSTRIAE: larger, full thickness folds in the cornea that usually cause noticeable visual problems and may require surgical intervention.

ETIOLOGY:

• Uneven alignment of the flap edge with the epithelial ring

RISK FACTORS:

• Thinner flaps are at an increased risk.

• Longer ablations (because of dehydration).

MANAGEMENT:

• In early postoperative period: lift and hydrate the flap and then stretch it back into position.

• Flatten with microsponges.

• Apply BCL.

• Late management: Reposition the flap and suture, PTK (in recalcitrant cases).

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Image from Rajan Eye Care Hospital⁣

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