flap relift for enhancement

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flap relift for enhancement

Postby knight » Thu Feb 01, 2007 8:36 pm

Is it true that the longer you wait for enhancement, the harder it will be to relift the flap and cause problems when the tool the doc uses to relift pushes bunched up cells under the flap? I have heard the tool is a dull flat instrument.
I have read in a ophthalmology web sight that the flap only adds about 2% of structure to the cornea after healing.Is this true?
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Postby LasikExpert » Thu Feb 01, 2007 10:25 pm

The Lasik flap provides a little structural strength to the overall cornea. The 2% number you quote is about right. This is why it is so important that the untouched cornea underneath the Lasik flap be at least 250 microns thick to maintain corneal stability. More is always better, but 250 microns has held up over the past five decades as the bottom number for a healthy cornea. Nobody counts on the Lasik flap keeping the cornea stable.

Lasik flaps have been lifted as much as 12 years after initial surgery. Separating at the location of the initial surgery is a more acurate description.

Whether one day or one decade later, it is always necessary for the surgeon to be careful to not introduce epithelial cells under the Lasik flap. If the epithelial cells grow and multiply (epithelial ingrowth), then the Lasik flap will need to be lifted and the cells removed. This is a relatively benign condition if resolved in a timely manner, but something you want to avoid where possible.

A surgical tool often used to lift the Lasik flap looks similar to a tiny stainless steel hockey stick.
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Postby knight » Fri Feb 02, 2007 12:06 am

What thickness are lasik flaps cut at? My post lasik cornea thickness was 450 microns. Does that measurement include the flap? Flap was done with blade. Can they measure flap and cornea individualy?
I recently found out my brother who is 15 years older than me has keratoconus and have read if you or a family member have this condition you shouldn't have lasik. None of the 5 different docs I have been too have seen any signs of this. In my original post in the just had it you mentioned undiagnosed keratoconus. Can one have this and it not be seen by docs? My only hope to fix my complications was an enhancement once my dry eye gets better. Now I don't know if I should have an enhancement that would make cornea thinner.
lasik = nightmare for me
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Postby LasikExpert » Fri Feb 02, 2007 2:18 am

Lask flaps are from about 90 microns to about 160 microns thick, with thinner being the preference of most surgeons. Your corneal thickness measurement was probably including the Lasik flap. There are special diagnostic instruments that make a cross sectional image of the cornea and can very precisely determine the exact thickness of the flap and of the untouched cornea.

A family member with keratoconus does not exclude you from surgery, however you would need to be evaluated if you have any signs of the disease. Keratoconus causes changes in the cornea and these changes can commonly be determined through evaluation. Like anything to do with medicine it is possible that a disease can be missed, however if you have been to five different doctors it seems highly improbable that all five would miss a diagnosis of something as obvious as keratoconus.
Glenn Hagele
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USAEyes

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Lasik Doctor Certification

I am not a doctor.
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