Could My Corneal Flap Become Dislodged?

“Could my flaps come loose?” is not something you want to hear no matter what context it’s said in.

But when you’re talking about a surgical procedure that involves your eyes, then it’s especially unwelcome.

For anyone wondering what a corneal flap actually is, we’ve got to look a little at how LASIK, the most common Laser Eye Surgery treatment, works.

Laser Eye Surgery works by reshaping the permanent tissue in the bed of the cornea called stoma. There are several methods which have been devised to reach this tissue by first passing through the epithelial tissue, and which typically form the basis for what makes one treatment different to the next.

The way LASIK does this is by creating a tiny circular doorway or flap of tissue. This flap can then be neatly folded back while the surgeon accesses and reshapes the underlying stoma.

Now we have some understanding of how the LASIK flap works and why we need it, we can turn to the all-important question…

Could I lose my flaps after Laser Eye Surgery?

Mr Carp explains how rare it is for the corneal flap to become loose as a result of Laser Eye Surgery.

As expert Laser Eye Surgeon Mr Glenn Carp explains in the video above, it is very, very rare for the corneal flap to loosen after having Laser Eye Surgery.

In the rare cases where loosening has occurred, it generally happens long after the actual treatment: a week after the surgery, a month, three months after the surgery.

This is because, for such an event to happen, the patient has to typically undergo some form of heavy trauma to the eye, resulting in not only the flap moving but also damage to other structures in the eye.

Rather than being a precaution for having Laser Eye Surgery, then, keeping your flaps in place is more a lesson in everyday health and safety and not putting them in places after having the treatment you wouldn’t have put them before.

Joking aside, the corneal flap attaches to the rest of the cornea by a hinge and once closed, the seams quickly merge into the surrounding tissue. So there is no chance of losing your flaps.

However, if you do rub your eye shortly after surgery, there is a small chance you may dislodge the corneal flap. In this case, the surgeon would have to reposition the corneal flap in the operating room.

There is an even smaller chance the microkeratome instrument will cut a free flap or “cap” without a hinge. This affects about one in 1,500 cases. If this happens, the surgeon will replace the cap after the laser part of the procedure and will simply tell you it has happened and warn you to take extra care not to rub your eyes soon after surgery.

Even in the days when surgeons did surgery without a hinge, it was extremely rare for anyone to lose this part of the cornea that a surgeon had cut and replaced.

If luck is seriously against you and the surgeon cuts a cap and your cap is lost, your cornea would become thinner, and there would be a chance of scarring. Overall, your vision would still probably be quite good, although surgeons consider this a serious complication. There would be a very remote possibility that you would need a corneal transplant.

So, there’s generally no need to worry and hold onto your flaps. That being said, you do want to keep the chances of complications down to a bare minimum by making sure you choose a clinic and surgeon that knows the treatment better than the back of their hands.