Wrinkles on the flap can they go away on their own

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Wrinkles on the flap can they go away on their own

Postby julsjuls » Sun Oct 01, 2006 5:05 am

After a large wrinkle on the flap was fixed I am told I have a little one still off to the side which is bothering me...and now told I have small ones on the other eye ....Intra lasik done Aug. 30th and the wrinkle on the right eye corrected Sept. 6th ...can these small wrinles go away on there own even after this amount of time? Thanks
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Postby LasikExpert » Mon Oct 02, 2006 7:21 pm

Whether or not the flap striae (wrinkles) will go away depends greatly upon the nature of the striae.

There are two kinds of striae; macrostriae and microstriae. Macrostriae are large folds in the flap similar to a rumpled comforter on a bed. Microstriae - also called Bowman's Crinkles - are smaller wrinkles within the flap caused by an imbalance in internal stresses.

Macrostriae does not often resolve on its own and if the striae are interfering with vision a flap lift is often the prescribed response. Microstriae tend to resolve with time and a flap lift may not be helpful.

We have a detailed article about Lasik flap wrinkles that you may find helpful.
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Postby DryEye » Fri Nov 24, 2006 5:57 pm

Do you know of any studies on the average time that microstriae has resolves itself (low end in terms of months to high end)?

If it only occurs in like .005% of lasik outcomes - does anyone know why or studied why? Do you know of any experts on this topic?

Also, if one did develop microstriae after initial custom lasik could an enhancement down the road if necessary be done or would the whole cycle start all over again?

Best to just leave things alone?

Thanks
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Postby LasikExpert » Fri Nov 24, 2006 7:09 pm

With microstriae it is almost always best to leave things alone.

You can visit PubMed.com and do a search on "microstriae" to find several peer reviewed medical journal articles about microstriae, including an interesting one about using rigid contact lenses to help resolve these tiny flap wrinkles.

Enhancement surgery is designed to resolve refactive error. Microstraie is not refractive error, so enhancement surgery. Enhancement surgery would be like changing the battery because you are out of gas.
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Postby DryEye » Fri Nov 24, 2006 11:23 pm

So, if there is slight refractive error, say -.50 and slight astigmatism an enhancement could be done with microstriae in place from before? If contacts were to become an option are they safe to use in a post lasik eye vs a non lasik eye? Any studies on post lasik contact lens wear?
Are the ones who don't end up needing an enhancement, glasses, contact lens or just living with the results getting to plano or better?
Thanks
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Postby LasikExpert » Sat Nov 25, 2006 9:08 pm

It may be possible to correct residual refractive error with enhancement surgery, but whether or not enhancement surgery would be appropriate would depend upon the unique circumstances of the individual after evaluation by the surgeon.

Contact lenses may be used after Lasik. Gruenauer-Kloevekorn et al published in Eye Contact Lens. 2006 Sep;32(5):233-9. Varieties of contact lens fittings after complicated hyperopic and myopic laser in situ keratomileusis.
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Postby DryEye » Sun Nov 26, 2006 6:57 pm

If an enhancement were to be done is there a timeframe where the flap may still be lifted without doing a whole other flap? In your opinion is it best to wait a year or more if one is borderline to see if more regression occurs or try to do it within the 6 months timeframe? Also, if one did develop microstriae is the 6 month rule on optimal vision results still the same as one who did not develop microstriae? In other words, could the individual with microstriae take longer to get the end result than a person who did not develop microstriae?
Thanks
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Postby LasikExpert » Sun Nov 26, 2006 7:55 pm

The Lasik flap can be surgically separated many years after surgery. This is one of the natures of Lasik flap healing.

Microstriae may affect vision quality, but will not affect corneal healing. Striae is caused by competing internal stresses in the Lasik flap. Those stresses may continue to change long after the cornea has healed. Microstriae may take a long time to resolve, sometimes more than six months.
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