lifting flaps after many years

#2 03-03-2004, 06:03 PM

k7qa[at]aol.com (Mack) wrote in message news:<fdb5718d.0403022317.5df8550a[at]posting.google.com> ...

- quote -

> He said ... 2 years was about the max
> for successfully lifting of original flaps without doing or risking
> damage. Obviously people heal differently and some better than others.
> Some apparently so well that no hint of an edge or scar is left.
> Without that how could relifting even be possible at all?

Certainly depends a lot not only on healing but also on
characteristics of the original flap - irregularities could make it
high risk to attempt to lift.

I had a flap lift in one eye at 2.5 years postop. When I was lying on
the table the surgeon had difficulty locating the edge and we
ultimately ended up going over to another slitlamp so he could find
and mark it. Breaking the epithelial seal seemed to be a challenging
process but then getting the flap up, and back down, was smooth &
uneventful. But I would never have considered having this done by any
other than the best hands I could find.

#1 03-03-2004, 12:31 PM

k7qa[at]aol.com (Mack) wrote in
news:fdb5718d.0403022317.5df8550a[at]posting.google.com:

- quote -

> We keep seeing stories about how the lasik flap can be lifted many
> years after lasik and so called "complete" healing. After 3+ years and
> considering re-enhancement for some small residual + astig, I had a
> doc tell me before an exam it would not be a problem. He had done
> thousands of relifts and had managed to lift most all he said. It's
> just all about the correct technique to get them to "pop". After a
> look under the slit lamp, he was very quiet. I asked if there was a
> problem. Dead silence. I then asked if he could see the edges of the
> flap. He finally responded he saw a faint remnant of part of the upper
> edges. Nothing else. After turning off the light, he said if he
> couldnt "get it up" he'd just cut a new flap no porblem. I told him I
> wasn't interested in that or adding yet more chances for
> complications. I then asked my original doc about lifting flaps at say
> 4 or 5 years out after wavefront is likely perfected and improved
> enough for FDA approval for + astig correction. He said no way for
> relifting and a new flap would be needed. 2 years was about the max
> for successfully lifting of original flaps without doing or risking
> damage. Obviously people heal differently and some better than others.
> Some apparently so well that no hint of an edge or scar is left.
> Without that how could relifting even be possible at all?

Recently, someone in this NG cited a study concluding that lifting flaps is
preferred to recutting in most cases. I have also been told by one noted
surgeon that anybody who says that a flap cannot be relifted, regardless of
the date of the original surgery, just hasn't had enough experience.

On the other hand, I have seen people who have had relifts, and the edge of
the flap looks rough, i.e. there is occasionally some stand-off of the flap
edge such that a ridge exists. Was this just sloppy technique, or did the
flap become stretched and distorted because it was difficult to lift. One
of these was done by a very well-known surgeon, and so I don't think it was
bad technique.

I have seen some flaps where the margin was very difficult to detect, and I
have seen some original flaps where the margin was fibrotic and easily
visible. It could very well be that the lack of a visible edge just meant
that it would be more difficult for your surgeon to identify the location
of the edge, and not that it couldn't easily be lifted.

It appears that the controversy continues.

DrG

03-03-2004, 08:45 AM

Sounds to me like your flap healed so well it can't be relifted. And
you are complaining? A skilled surgeon can lift a flap. There is no
crime in cutting a new flap. Lifting is the preferred method that has
better results.
I have a hunch your doctor didn't want to do an enhancement on you and
was trying - successfully - to discourage you.

Many years ago, I asked an optometrist about RK surgery. He wasn't a
fan of it. That was before the days of PRK and LASIK. To discourage
me, he lied and said I had macular degeneration and couldn't have the
surgery. That was a complete lie. He scared the hell ouf of me. I
thought I would be going blind. Oddly, the OD that told me I had
macular degeneration so many years ago was the same OD that had
originally did my LASIK evaluation and set up an appointment for it.
I changed to a different OD and surgeon before I had my surgery.

On 2 Mar 2004 23:17:04 -0800, k7qa[at]aol.com (Mack) wrote:

- quote -

> We keep seeing stories about how the lasik flap can be lifted many
> years after lasik and so called "complete" healing. After 3+ years and
> considering re-enhancement for some small residual + astig, I had a
> doc tell me before an exam it would not be a problem. He had done
> thousands of relifts and had managed to lift most all he said. It's
> just all about the correct technique to get them to "pop". After a
> look under the slit lamp, he was very quiet. I asked if there was a
> problem. Dead silence. I then asked if he could see the edges of the
> flap. He finally responded he saw a faint remnant of part of the upper
> edges. Nothing else. After turning off the light, he said if he
> couldnt "get it up" he'd just cut a new flap no porblem. I told him I
> wasn't interested in that or adding yet more chances for
> complications. I then asked my original doc about lifting flaps at say
> 4 or 5 years out after wavefront is likely perfected and improved
> enough for FDA approval for + astig correction. He said no way for
> relifting and a new flap would be needed. 2 years was about the max
> for successfully lifting of original flaps without doing or risking
> damage. Obviously people heal differently and some better than others.
> Some apparently so well that no hint of an edge or scar is left.
> Without that how could relifting even be possible at all?

#-1 03-03-2004, 07:17 AM

We keep seeing stories about how the lasik flap can be lifted many
years after lasik and so called "complete" healing. After 3+ years and
considering re-enhancement for some small residual + astig, I had a
doc tell me before an exam it would not be a problem. He had done
thousands of relifts and had managed to lift most all he said. It's
just all about the correct technique to get them to "pop". After a
look under the slit lamp, he was very quiet. I asked if there was a
problem. Dead silence. I then asked if he could see the edges of the
flap. He finally responded he saw a faint remnant of part of the upper
edges. Nothing else. After turning off the light, he said if he
couldnt "get it up" he'd just cut a new flap no porblem. I told him I
wasn't interested in that or adding yet more chances for
complications. I then asked my original doc about lifting flaps at say
4 or 5 years out after wavefront is likely perfected and improved
enough for FDA approval for + astig correction. He said no way for
relifting and a new flap would be needed. 2 years was about the max
for successfully lifting of original flaps without doing or risking
damage. Obviously people heal differently and some better than others.
Some apparently so well that no hint of an edge or scar is left.
Without that how could relifting even be possible at all?

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