Slitlamp stretching of the corneal flap after laser in situ keratomileusis to reduce corneal striae

Solomon, Renée; Donnenfeld, Eric D; Perry, Henry D; Doshi, Sima; Biser, Seth

doi:10.1016/S0886-3350(03)00046-4

« Previous Next »Journal of Cataract & Refractive Surgery
Volume 29, Issue 7 , Pages 1292-1296, July 2003

Slitlamp stretching of the corneal flap after laser in situ keratomileusis to reduce corneal striae

Presented in part at the ASCRS Symposium on Cataract, IOL and Refractive Surgery, San Diego, California, USA, April 2001.

Renée Solomon, MD
- Ophthalmic Consultants of Long Island, Rockville Centre (Solomon, Donnenfeld, Perry, Dosh, Biser) New York, USA
- None of the authors has a financial interest in any product mentioned.
Eric D Donnenfeld, MD
- Reprint requests to Eric D. Donnenfeld, MD, Ophthalmic Consultants of Long Island, Ryan Medical Arts Building, 2000 North Village Avenue, Suite 402, Rockville Centre, New York 11570, USA.
- Ophthalmic Consultants of Long Island, Rockville Centre (Solomon, Donnenfeld, Perry, Dosh, Biser) New York, USA
- Nassau University Medical Center, East Meadow (Donnenfeld, Perry, Doshi, Biser), New York, USA
- None of the authors has a financial interest in any product mentioned.
Henry D Perry, MD
- Ophthalmic Consultants of Long Island, Rockville Centre (Solomon, Donnenfeld, Perry, Dosh, Biser) New York, USA
- Nassau University Medical Center, East Meadow (Donnenfeld, Perry, Doshi, Biser), New York, USA
- None of the authors has a financial interest in any product mentioned.
Sima Doshi, MD
- Ophthalmic Consultants of Long Island, Rockville Centre (Solomon, Donnenfeld, Perry, Dosh, Biser) New York, USA
- Nassau University Medical Center, East Meadow (Donnenfeld, Perry, Doshi, Biser), New York, USA
- None of the authors has a financial interest in any product mentioned.
Seth Biser, MD
- Ophthalmic Consultants of Long Island, Rockville Centre (Solomon, Donnenfeld, Perry, Dosh, Biser) New York, USA
- Nassau University Medical Center, East Meadow (Donnenfeld, Perry, Doshi, Biser), New York, USA
- None of the authors has a financial interest in any product mentioned.

Accepted 7 January 2003.

Abstract

Purpose

To examine the efficacy of treating immediate postoperative corneal striae and poor flap alignment by stretching the corneal flap at the slitlamp with a cotton-tip applicator and compare the results using this technique with those using the conventional technique of refloating the flap with balanced salt solution (BSS®).

Setting

TLC Laser Eye Center, Garden City, New York, USA.

Methods

Charts of 7154 eyes having laser in situ keratomileusis (LASIK) were reviewed retrospectively. During the 11 months prior to January 1, 2000, 3516 eyes had LASIK. Patients with flap striae or a malpositioned flap at the immediate slitlamp evaluation were treated by refloating the flap (Group A). During the 11 months subsequent to January 1, 2000, 3638 eyes had LASIK. Patients with flap striae or a malpositioned flap at the immediate slitlamp evaluation were treated by flap stretching with a cotton-tip applicator (Group B). The number of eyes that required retreatment for flap striae was analyzed.

Results

Twenty-nine eyes in Group A (0.82%) required retreatment for visually significant flap striae after day 1, and 11 eyes in Group B (0.30%) required retreatment. A loss of best corrected visual acuity occurred in 3 Group A eyes and 2 Group B eyes.

Conclusions

During the immediate postoperative period, stretching the flap with a cotton-tip applicator was a simple, safe, and effective technique for reducing visually significant flap striae. Unlike refloating the flap with BSS, flap stretching at the slitlamp does not require additional anesthesia, exposure time, or dehydration of the ocular surface.