61
EW REFRACTIVE
July 2018
Contact information
Wallerstein: awallerstein@lasikmd.com
difference between uncorrected dis-
tance vision and corrected distance
vision," Dr. Wallerstein said, adding
that 13% fewer striae-treated eyes
attained 20/20 uncorrected distance
visual acuity.
Also, the striae-treated eyes had
a little more cylinder magnitude
than the controls, Dr. Wallerstein
pointed out. As a result, striae
eyes were twice as likely to need
an enhancement with an excimer
laser than the non-striae eyes.
"Surgeons now know that about
6% of striae-treated eyes will need a
retreatment, compared to only 3%
of non-striae eyes," Dr. Wallerstein
said.
One study finding on flap thick-
ness ran counter to reports in the
older literature, which had indicated
that thinner flaps had higher rates of
striae, Dr. Wallerstein reported. "Our
findings did not support that," he
said. In addition, investigators think
that if the eyelid is taped shut for
a period immediately after surgery,
it may confer a protective effect
against striae. "That's not necessar-
ily a conclusion, but it's a sugges-
tion in that this is what our results
showed," he said.
Dr. Wallerstein also advised
practitioners not to wait around
once they've found clinically
significant striae. "Once you've
determined that this is potentially
clinically significant you should
treat it early," he said.
This is the first study that
looked at the outcomes of a surgical-
ly treated LASIK complication in a
multi surgeon standardized protocol,
Dr. Wallerstein pointed out. "What
we have is a LASIK complication,
then we treated it, looked at the
outcomes, and compared the out-
comes to a control," he said. "That's
the first time that's happened when
the protocol and the practices were
controlled and standardized." Also
important is the fact that this drew
from a large electronic medical
record database, he said, adding that
going forward, such data mining
will provide valuable information
that will allow for the continued im-
provement of patient outcomes. EW
Reference
1. Wallerstein A, et al. Clinically significant
laser in situ keratomileusis flap striae. J Cata-
ract Refract Surg. 2017;43:1523–1533.
Editors' note: Dr. Wallerstein has
no financial interests related to
his comments.
