What is a small flap? (Posted: jan 2005)

A small flap is a LASIK flap which is created either smaller than programmed, or smaller than desireable.

How does it happen? (posted: jan 2005)

Anatomical factors, including corneal steepness or flatness and the size of the eyes, can affect the size of the flap that is created. Additionally, sometimes the programmed flap size may simply be inappropriate for the patient.

What does it mean for the patient? (posted: jan 2005)

A LASIK flap needs to be large enough to treat the appropriate amount of cornea. (There is no incentive to make it larger than necessary, since by cutting more nerves it could increase dry eye problems for the patient.) The most common problem with a small flap is that it may be attended by a small ablation - i.e. too small for the patient's needs. In such a case if the flap is too small for a retreatment designed to enlarge the optical zone, it will greatly complicate or impede the surgical options for improving the patient's vision.

How is it diagnosed and treated? (posted: jan 2005)

A small flap as such does not require treatment. If a patient needs and wants to have a larger area of cornea treated, there are a couple of different possibilities. An over-the-flap (PRK) treatment could be performed, so that the flap is not interfered with. Or, a new flap might be cut - if the patient has sufficient residual stromal thickness.

For patients with small flaps and small optical zones, gas permeable contact lenses are still the most reliable and safest method of improving their vision.