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