Repositioning the Laser in situ Keratomileusis Flap at the Slit Lamp

Abstract

PURPOSE: To describe the indications and technique for repositioning the laser in situ keratomileusis (LASIK) flap at the slit lamp. METHODS: We present a description of patients with striae or slippage of the flap who had repositioning of the flap at the slit lamp. RESULTS: Indications for repositioning at the slit lamp are mostly flap striae. However, it can also be done for a displaced flap and small amounts of debridement. This procedure is not recommended for taking cultures, irrigation of diffuse lamellar keratitis, suturing the flap, or epithelial ingrowth. Repositioning the flap is done by finding the edge of the flap with the cannula, lifting the flap, sweeping the cannula to release the entire wound, and infusing balanced salt solution under the entire flap. We did not encounter infection or recurrent epithelial erosion in these patients. CONCLUSIONS: Repositioning the LASIK flap at the slit lamp was effective and safe in the treatment of striae or flap slippage. It saved time, money, and, anxiety for the patient. [J Refract Surg 2004;20:166-169]

Late post-traumatic flap dislocation and macrostriae after laser in situ keratomileusis

“…Methods to prevent recurrence have included the use of absolute alcohol and flap suturing which is mostly required in late cases. [ 6 7 8 ] More recently, a method of sealing the flap edges with fibrin glue in recurrent epithelial ingrowth has been described, a method that may help prevent the invasion of epithelial cells while the flap adheres to the stromal bed. [ 9 ]…”