Management of folds and striae in the cornea flap after laser in situ keratomileusis

Abstract

Objective To investigate the efficient treatment of cornea flap folds and striae after laser in situ keratomileusis (LASIK).To review the management and results of cases with severe flap wrinkling or dislodgment after LASIK.Methods Eleven patients with cornea flap folds and striae after LASIK are described.To make retrospective analysis of etiology and treatment in 11 cases who had cornea flap folds and striae after LASIK.Surgical repositioning of the flap was performed in all cases.Under the operating microscope the flap was refloated and hydrated with sterile deionized water for 2 minutes without stretching or ironing the flap.A bandage contact lens was then applied for 24 hours.Flap status,refractive changes,and final uncorrected and best corrected visual acuities were used to evaluate the outcome of flap repositioning.Results Relocation flap and bandage contact lens were used in such cases.Scraping epithelial and hydrating the cornea flap with sterile deionized water were used under operation.Twenty-four hours after treatment with sterile deionized water and a bandage contact lens,the cornea was smooth and wrinkle free.All patients who received those treatments had regalned the best-uncorrected visual acuity.Cornea was clear and had no obvious folds and striae.The flap had perfect location and no epithelial cell ingrowth.Conclusion Flap dislodgment and wrinkling are serious postoperative complications of LASIK.Early recognition of these complications and prompt surgical management are crucial to achieve a successful surgical and visual outcome.Relocation flap、hydration the cornea flap with sterile deionized water and a bandage contact lens may be a safe and efficient choice in such cases. Key words: Laser in situ keratomileusis (LASIK); Cornea flap folds