title: Slitlamp stretching of the corneal flap after laser in situ keratomileusis to reduce corneal striae.
abstract: OBJECTIVE
  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(R)).
  
  
  METHODS
  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.
authors.affiliation: Ophthalmic Consultants of Long Island, Rockville Centre, New York, USA.
authors.forename: Renée
authors.initials: R
authors.lastname: Solomon
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnenfeld
authors.forename: Henry D
authors.initials: HD
authors.lastname: Perry
authors.forename: Sima
authors.initials: S
authors.lastname: Doshi
authors.forename: Seth
authors.initials: S
authors.lastname: Biser
mesh_terms: D003315:Cornea / Q000503:physiopathology* / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D003319:Corneal Stroma / Q000473:pathology; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D019233:Retreatment; D012189:Retrospective Studies; D013314:Stress, Mechanical; D013524:Surgical Flaps / Q000009:adverse effects*; D014792:Visual Acuity