What Keeps the Corneal Flap in Position After LASIK Surgery?

For a lot of people, just the thought of anything touching their eyes is enough to put them off Laser Eye Surgery altogether – and as a Laser Eye Surgery Clinic, we still see a lot of people for whom this is the case. So, hearing about a “corneal flap” during your Laser Eye Surgery research is unlikely to set your mind at ease.

If you have already done a bit of research into Laser Eye Surgery, you may well have learned a bit about how LASIK surgery works. But let’s cover the basics of the procedure – just in case – including the dreaded “corneal flap”.

What is LASIK Laser Eye Surgery?

The term “Laser Eye Surgery” actually refers to a number of procedures that correct refractive errors with the help of laser technology. The three key kinds of Laser Eye Surgery procedures are SMILE, LASEK/PRK (the surface procedures), and – you guessed it – LASIK.

LASIK – which stands for Laser-Assisted In Situ Keratomileusis – is the most commonly performed procedure. It was introduced commercially in the UK in 1991 and for the last 30 years has helped to correct the vision of millions of people around the world. So, how does it work?

Laser Eye Surgery works by removing a pre-determined amount of tissue from the corneal bed to change the way light refracts into the eye. This allows light to be focused on the retina more effectively, correcting any impairment caused by errors such as myopia (short-sightedness), hyperopia (long-sightedness), and astigmatism. This is achieved using a high-precision laser to create a “flap” in the surface of the cornea – A.K.A. the corneal flap – which is put back in place to heal once the procedure is complete.

What keeps the corneal flap in position?

At this stage, you’re probably wondering what prevents the corneal flap from re-opening following Laser Eye Surgery. Are stitches or sutures required? Actually, no! This is thanks to the almost miraculous healing power of the cornea combined with the minimally invasive nature of the procedure. In fact, the flap begins to heal almost immediately once it is closed after LASIK surgery and there is almost no chance of it even moving!

What Happens to the Corneal Flap After LASIK Surgery?

To close the door for good on the issue of the corneal flap (pardon the pun), let’s take a look at what happens after surgery. In the video below, Mr. Glenn Carp explains what keeps the flap in position and provides some extra advice for patients after Laser Eye Surgery.

Youtube video link

As Mr. Carp explains, almost immediately after Laser Eye Surgery the flap is returned to its original position it is held in place by an osmotic gradient force. This is linked to the balance of fluid and pressure in the eye.

The cells lining the inner surface of the cornea, known as the endothelial cells, pump water to the inner part of the eye creating a suction effect that holds the flap in place. Over the next couple of days, the outer surface of the cornea (the epithelium) begins to seal the edges of the flap. Within a few weeks, the flap will have once again become completely bonded to the underlying tissue.

Could the Corneal Flap Become Dislodged?

As Mr. Carp explained in the video above, it becomes difficult to dislodge the corneal flap even after just a matter of days. Such events are extremely rare, but that doesn’t mean it is impossible.

In the rare cases where this does occur long after the procedure, it is likely that the patient has experienced some form of heavy trauma to the eye, resulting not only in the flap moving but also in damage to other structures in the eye, as Mr. Glenn Carp explains in the video below.

Youtube video link

Nonetheless, it is important to follow any guidance from your surgeon during your recovery, including wearing any eye protection that is given to you for the recommended duration and avoiding rubbing or irritating your eyes as this can increase your risk of dislodging the corneal flap.

In extremely rare cases (around one in every 1,500), the corneal flap may accidentally be removed by the microkeratome instrument during the procedure. In these cases, the corneal tissue (called a “cap”) can still be put back in place following the correction (this is also done in LASEK).

To sum up, the LASIK corneal flap is like a temporary wormhole; it opens once, and then it disappears. That means, as long as have your treatment at a high-quality clinic and with an expert surgeon, then you have absolutely nothing to worry about.

If you’re worried about any other aspect of Laser Eye Surgery treatment, don’t hesitate to get in touch with one of our friendly clinic coordinators today – they’re always on hand to help! Alternatively, if you’d like to learn more about your suitability, Book a Consultation today.