title: RK4 lens fitting for a flap striae in a LASIK patient.
abstract: OBJECTIVE
  To present a case in which an RK4 lens was fitted for a patient who developed flap striae resulting from laser-assisted in situ keratomileusis (LASIK).
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 44-year-old man underwent uncomplicated LASIK procedure for bilateral myopia and astigmatism. Visually significant flap striae (OS>OD) were noted postoperatively. The flaps were relifted, refloated, and stretched twice in each eye. In addition, OD enhancement laser treatment was performed. Nevertheless, decreased best-corrected visual acuity (OS>OD) persisted. One month after LASIK, the patient was referred to our office for a second opinion and further evaluation. To avoid additional manipulation of the flaps, we used an RK4 lens fitting to achieve a final corrected visual acuity of 20/20 OU.
  
  
  CONCLUSIONS
  Persistent, visually significant flap striae following flap, refloating, stretching, and smoothing techniques can make LASIK patients unhappy. An RK4 lens fitting is an alternative method for correcting postoperative irregular astigmatism and to achieve the best-corrected visual acuity.
authors.affiliation: Department of Opthalmology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA.
authors.forename: Jen-Chieh
authors.initials: JC
authors.lastname: Lin
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Cohen
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000601:surgery; D003261:Contact Lenses; D003316:Corneal Diseases / Q000209:etiology / Q000628:therapy*; D003319:Corneal Stroma / Q000473:pathology*; D019781:Corneal Topography; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009216:Myopia / Q000601:surgery; D017755:Prosthesis Fitting; D013524:Surgical Flaps / Q000473:pathology*; D014792:Visual Acuity