Lasik Flap question. How durable are they?

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Lasik Flap question. How durable are they?

Postby traveler » Sun Jun 08, 2008 9:33 pm

I had lasik February 1st and had a flap revision February 2nd, I ended up with some wrinkles as I woke up with my eye guards stuck to my mattress at 4am. I must have removed them and rubbed my eyes in the middle of the night. According to my eye doctor the flap is doing fine and apparently has no issues. My lasik surgeon just told me to do my best to try and forget about my surgery. Just to live my life normally. I like the advise but I have dry eye as a constant reminder of my Lasik procedure. Though my dry eye has significantly improved, it is annoying but tolerable.

I am 4 months post op and I do not touch my eyes at all. I only touch them when I shower to wash my lids gently with a very soft baby wash cloth & antibacterial soap. I only wipe my eyelids from up to down and I am so insanely gentle with them. I am just wondering when can I vigorously scrub my face again while showering? What about wiping sweat from my brow? I always approach my eye area with great caution now as I do not want to disturb that flap. I am a fairly active person who enjoys snowboarding, mountain biking, and occasionally I throw myself out of an airplane just to allow me to feel really alive. I kind of regret not doing more research as I may have just stuck with contacts. However my eyesight is very good now and my dry eye seems to be improving. So as far as the refractive surgery has gone I wish that I would have gotten, Lasek, Epi-Lasik, or Prk so as to not have the flap to worry about. So how durable are these flaps? Can I skydive with these as long as proper eye protection is worn? I know that the military has done a lot of research and many soldiers including those in the special forces have had refractive surery. I guess that can be an indication of flap durability?
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Postby traveler » Sun Jun 08, 2008 9:53 pm

I found this.

"Laser In Situ Keratomileusis Flap Stability During Simulated Aircraft Ejection in a Rabbit Model.

Basic Investigations
Cornea. 22(2):142-145, March 2003.
Goodman, Randall L. M.D.; Johnson, Daniel A. M.D.; Dillon, Harold M.D.; Edelhauser, Henry F. Ph.D.; Waller, Stephen G. M.D.

Purpose. To determine the stability of the laser in situ keratomileusis (LASIK) flap in a rabbit model when subjected to vertical acceleration at nine times the force of gravity (+9 Gz) in an aircraft cockpit ejection simulator.

Methods. Thirty-six eyes from 25 New Zealand white rabbits underwent LASIK flap creation without laser photoablation. One month after surgery, the rabbits were sedated and harnessed in a cockpit ejection seat simulator used to train United States Air Force pilots. They then underwent a controlled rapid-sequence ejection at +9 Gz. Subsequently, the rabbits were euthanized and the corneas harvested for microscopic examination. Refractive measurements and corneal examination were made before LASIK flap creation and prior to and after the +9 Gz ejections. Determination of LASIK flap dislocation was based on clinical observation of flap slippage or a significant shift in pre-ejection to postejection cylinder axis.

Results. The average preoperative refraction of the rabbit eye was +1.83 D + 3.25 D x 086 degrees. The average change from pre-ejection to postejection was 0.04 D sphere, 0.02 D cylinder, 6.8 axis degrees, and 0.04 D spherical equivalent. The pre-ejection to postejection measurements were not statistically significantly different by a paired t test. Laser in situ keratomileusis flap dislocation or ejection-induced corneal folds or striae were not clinically observed. Histologic examination revealed well-healed LASIK flaps but no reactive keratocytes at the central stromal-stromal interface.

Conclusions. Healed LASIK flaps as created in this rabbit model without laser ablation are stable when subjected to a rapid vertical ejection at nine times the force of gravity.

(C) 2003 Lippincott Williams & Wilkins, Inc. "
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Postby lboogie » Sun Jun 08, 2008 10:22 pm

I've been told that flap problems are very rare. And that intralase flaps adhere better than the microkeratome flaps.

That study is funny -- I'm picting white bunnies flying through the air! While I am against animal testing-- now that I am dealing with so many pos-lasik issues, I'm glad that testing is being done.

Hang in there -- I'm 6 months post op and still really struggling with dry eyes and starbursts.
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Postby BAM17 » Sun Jun 08, 2008 10:45 pm

hey traveler,
I feel your anxiety! I had bilateral flap dislocation about 4 hours after my Lasik procedure....basically, my eyes dried out and when I went to blink, my eyelids stuck to the flaps and dislocated them. I had to go back to the surgeon immediately...where he "re-floated" my flaps, and but a bandage contact lense in for a couple of days. I think those of us who have had flap issues are so highly aware...but keep in mind, our flap issues happenend immediately after the surgery. Since then, I've had no flap striae, etc. I don't rub my eyes...but think of it this one should rub their eyes. You can transmit infections to your eyes, or into your body via your eyes....and rubbing your eyes is not healthy for your cornea. So never rubbing your eyes again is actually a good habit to get into. For sports etc., just make sure you have protective eye wear on and you will be fine. And from what I've read, those that have had flap issues months/years down the road, the flap is usually re-floated and heals again successfully. My MD told me about a case where a man had an airbag deploy in his face 4 years after Lasik which dislocated his flap. It was repositioned....healed....and he regained 20/20 vision in that eye. Hope this helps with your flap anxiety...I can totally relate!
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Postby Rocksville » Tue Jun 10, 2008 10:56 pm

I'm in the same boat as you. I had DLK in one eye, and they lifted the flap 4 days after the original surgery to rinse it out.

I'm about 7 weeks post op and last week at a routine follow up I asked my dr just how sensitive the flap is and how long I would need to go before I could gently rub my eyes. He said that rubbing my eyes at this point was bad more for it's ability to transmit germs etc into the eyes than for it's ability to dislodge the flap. I asked if it was ok to gently rub my eyes in the shower when everything is clean and he said it would be fine, but not to really go to town on them.

I had worn contacts for so many years that I really never rubbed my eyes anyway, but at least now I'm not nearly as paranoid about accidentally brushing up against my eye. I still haven't rubbed them, but I'm not really fearful of it should they feel like they need it.
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Postby LittleAsianguy » Sun Jul 27, 2008 9:27 pm

How durable is the flap? In my case after 1 1/2 yrs after lasik surgery i got punched in the eye and had blurryness for about 5 mins. Then was worried something would happen to the flap but eyesight was crystal clear.. Of course everybody situation is different. Now life is good just stop worrying too much about the flap and enjoy life :wink:
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