Removal of flap striae following laser in situ keratomileusis

While laser in situ keratomileusis (LASIK) offers advantages over photorefractive keratectomy (PRK), creation of the corneal flap has been associated with postoperative flap striae. These result from misalignment of the corneal flap after flap replacement, movement of the corneal flap during the first postoperative day, or the "tenting effect" of the corneal flap over the ablated stromal bed. Flap striae become more difficult to remove as the postoperative course progresses; therefore, identifying the striae on the first postoperative day is imperative. We describe techniques of flap hydration, refloating, stretching, and smoothing that we use to remove visually significant flap striae.