As I understand it, laser eye correction consists of slicing a thin ‘flap’ on the cornea, removing/re-shaping some of the material underneath and then re-laying the flap in place over it again (I presume this is done to preserve a nice smooth outer surface to the eye.
But I heard a claim somewhere or other to the effect that ‘The flap never heals’ - i.e. it stays in place by cohesion, but never actually binds back to the tissues from which it was cut.
I can’t see how this could be true and not cause severe problems in some patients; debris or pathogens could get in there and cause problems, heck, it could suffer mechanical damage if the patient opened his/her eyes underwater while swimming or something.
It has a scar (which can lead to seeing auras around lights at night), so of course an oftalmologist will look at it and know your eye got cut. But if that isn’t “being healed” - help! My navel ain’t healed yet!
First I’ve heard of it. I had mine done on Jan 2, 2001 and my surgeon told me it would be healed up in fairly short order. I’ve never had reason to doubt.
For reference, here is an example of a site making the claim (and also making no end of other alarming claims, paranoid rants, etc - am under no illusion regarding the nature/veracity of the linked website).
Actually, googling the quote-enclosed phrase “the flap never heals” seems to suggest that this claim is being upheld by only a very small number of prolifically loud nutcases.
If you include the US military in this group of nutcases, this may be the case, but at least until recently they only allowed PRK for pilots, rather than LASIK. PRK ablates or “burns off” the top layer of the cornea, so it has to completely regrow rather than simply reattach. This leads to a longer and more painful healing process, but avoids flap detachment. I believe the military is now conducting trials with standard LASIK, but there was until recently significant worry that under high-g conditions the flap could detach.
To answer the OP’s question, the flap never completely heals. You can’t generally get LASIK twice on the same eye, as you can with PRK. And of course, as Nava pointed out your ophthalmologist will see it.
To answer the OP’s concern, the flap does heal. If you are not a military pilot (or perhaps a boxer?) your eyes are unlikely to experience enough stress to detach the flap. Certainly not while swimming. After healing there is no worry of debris getting in there,
Euh, my LASIK includes a second bout of surgery if the first one doesn’t leave you 20/20. Lifetime eye exams, too. That second surgery may be a different procedure (not doubting you, I simply never needed to ask), but still it doesn’t sound so different from having, say, a second cesarean.
Thanks for this; do you have such a thing as a citation regarding the military connection? Not that I’m doubting you, just that there seems to be a fairly high noise-to-signal ratio in this particular topic and I’m having trouble finding any information that isn’t flecked with foam and spittle.
Even if the cornea never again fused entirely, there would be no question of pathogens getting. The cornea is covered by tissue called the epithelial layer. In PRK, this layer is completely removed, and then cornea is shaped. The epithelial layer then takes a month or two to regrow. (The top of the cornea doesn’t regrow as suggested by a previous post.) In LASEK, the epithelial layer is sliced along with the cornea, which is why healing times are shorter. It quickly regrows, sealing any scar left in the cornea.
Sorry, I know the rules. Just in a hurry. Here is a (weak) cite that says a waiver is likely but that if you have had LASIK prior to entry it will DQ you as an aviator. http://usmilitary.about.com/od/navy/l/bllasersurgery.htm
actually both LASIK and PRK are disqualifying, but for PRK you can get a waiver in the PRK evaluation program.
For the second LASIK cite, I should have said that thin corneas are counterindicators for LASIK more than for PRK. People who were previously were on the threshold of getting LASIK before the operation may no longer qualify (I should have said “cannot generally” rather than “generally cannot”). I withdraw the general assertion that it cannot be redone, though I never meant to exclude the quite common follow-up LASIK.
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PRK patients wear a medicated contact lens to cover the exposed corneal tissue as the epithelial layer regrows. There is a visible (to your ophthalmologist) scar on the cornea following LASIK, but it is not in the field of vision. I believed the question to be about the lasting effects rather than the first month or so. Yes, the eye is healed in a few days with LASIK. PRK healing takes a couple weeks. Both settle over somewhat longer time periods.
US Naval Special Warfare used to ban LASIK on the grounds that the cut would be a weak point on the eye which may have failed at the pressures at which its people would operate. LASIK is now allowed.
I can give an example from my personal experience. I had LASIK surgery in 1999 and never had any problems with the flap. As far as I was concerned, it was totally “healed.”
Last month I went to my eye doctor to see about a “tuneup.” The vision in my right eye was not quite 20/20, and I wanted them to adjust my left eye for “monovision” so that I could do away with my reading glasses.
To make a long story short, the doctor was able to use his little tool and lift up the existing flaps without having to make a new incision in the cornea. This is apparently the usual method for repeat laser surgery. In a few cases, this is not possible, but it usually is.
I should add what the doctor told me about repeat surgeries like this. He said that in about 1 in 30 cases of repeat LASIK surgery, some epithelial cells can get in under the flap when it is reclosed, and then they have to go in again and scrape them off, but it is not a major risk.
As I said in my previous post, after the initial surgery, there was never any problem with the cornea tissue coming loose or getting infected or anything else. It was “healed” even though the remnants of the incision remained.
