What is an irregular flap? (Posted: jan 2005)

An irregular flap is a flap which has some irregularity of thickness and/or shape.

What causes an irregular flap? (posted: jan 2005)

Possible causes include loss of suction during the creation of the flap and anatomical abnormalities. Generally speaking, flap complications occur more frequently with patients who have very flat or steep corneas or small or deep-set eyes.

What are the potential results for the patient? (posted: jan 2005)

This depends upon how irregular the flap is and how it is handled. A flap can be somewhat thinner or thicker in some spots than others without interfering with treatment or producing significant symptoms. However, the big risk with irregular flaps is buttonholes or other damage to the flap during handling; or, if no further complication results during surgery, it may pose a greater risk for the patient if a retreatment is needed. Irregularities in the flap may also increase the risk of epithelial ingrowth or inflammatory or other problems arising in the flap interface.

How is it diagnosed? (posted: jan 2005)

Unless there is a very overt damage occurring as a result, thickness irregularities may be anything but apparent to the surgeon during surgery. After surgery, flap thickness at any given point is not visible through the slitlamp or measureable with any commonly used equipment. Flap thickness may be measured with confocal microscopy or Artemis VHF digital ultrasound.

How is it treated? (posted: jan 2005)

The flap itself does not need treatment unless it results in further complications. If detected, flap thickness irregularities should be cause for not proceeding with the laser ablation. If detected only after surgery through a specialised examination, it would have to be taken into account for any future surgical treatment plan.