Flap Complications after LASIK

Since its inception, LASIK has proven to be one of the safest and most consistently successful surgeries in all of medicine. Serious complications are exceedingly rare, and most complications that do occur are mild and temporary. In traditional LASIK, the most common side effects result from complications related to the corneal flap, the hinged flap that is created in the outermost layer of the cornea in order to access the underlying tissues that are to be reshaped by the excimer laser. At Black Hills Regional Eye Institute, our laser eye surgery center in Rapid City, LASIK flap complications are largely avoided through the use of a laser to create the corneal flap.

Why Flap Complications Occur in Traditional LASIK

No matter which technique is used to perform LASIK, flap complications are a risk; however, the risk is somewhat higher with traditional LASIK than with the iLASIK performed at Black Hills Regional Eye Institute. This is because a handheld blade called a microkeratome is used to create the flap in the traditional version of the procedure. Although the microkeratome is a precision device that has been used safely in millions of LASIK procedures through the years, it is not as precise as the computer-controlled laser used to create the flap in iLASIK. As a result, minor, although not usually serious or long-term, complications with the flap can occur, including:

  • Flaps that have slightly jagged edges or are otherwise irregular in shape
  • Flaps that are too thin or uneven in their width
  • Small holes or tears in the center of the flap
  • Flaps that become unhinged
  • Flaps that are incomplete
  • Small wrinkles in the flap (called striae)

In general, these complications are rare, even in traditional LASIK, and they do not cause major problems with vision or the anatomical integrity of the eye. In most cases, any flap-related problems that do occur will either subside over time or be easily treated by an ophthalmologist.

Of course, the avoidance of flap complications altogether is preferable, as it makes for smoother, quicker post-operational healing and better overall results. By replacing the microkeratome with a laser in the flap creation phase, the possibility of even slight human error is eliminated. The computer-controlled laser makes incredibly precise incisions in the stromal layer of the cornea, using data collected by a wavefront mapping device to create hinges of uniform depths and widths. The edges are perfectly straight, and the hinges are sufficiently strong to ensure proper replacement of the tissue and excellent healing.

This does not mean that flap complications cannot occur after iLASIK, but they are significantly less common than with traditional LASIK. Patients who undergo iLASIK will have to follow the post-operational instructions provided by our practice to the letter to reduce the risk of flap complications, as the simple act of rubbing one’s eyes during the healing period can create striae.