What Happens If Lasik Flap Is Lost?

LASIK eye surgery offers hope to those looking to free themselves from glasses or contact lenses. With its reputation for high success rates and swift recovery, it’s no wonder it’s a top option for vision correction.

However, as with any surgical procedure, complications, though very rare, can occur. One such serious complication patients may wonder about is the loss of a LASIK flap. But, what happens if a LASIK flap is lost? Does it spell disaster for the eye, or are there contingency plans in place? 

In this article, we investigate the implications of this complication, its causes, potential consequences, and the options for treatment.


Understanding the LASIK Flap

The LASIK procedure involves creating a hinged flap on the surface of the cornea using either a femtosecond laser or a microkeratome blade. This flap is then lifted so that an excimer laser can reshape the underlying corneal stroma to correct refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), or astigmatism. Once the cornea is reshaped, the flap is repositioned to heal naturally—no sutures needed.


Losing the LASIK Flap: How Rare Is It?

The incident of a patient losing a LASIK flap post-surgery is exceptionally infrequent, happening in less than one out of a hundred cases, typically within 24 hours post-operation. Advancements with femtosecond laser technology have further decreased the already slim risks of this happening compared with older, blade-based methods.


Reasons Behind a Lost LASIK Flap

The loss of a LASIK flap can happen due to:

  • Accidental Dislodgement: Although extremely rare, the flap could be dislodged during the surgery by sudden patient movements or technical issues.
  • Post-Surgery Trauma: Any severe blow or rubbing of the eye, particularly in the initial weeks after surgery, could potentially dislodge the flap.
  • Issues with Flap Creation: An incomplete or compromised initial creation of the flap can make it more susceptible to dislodgement.
  • Pre-Existing Corneal Conditions: Certain corneal conditions like loose epithelial tissue (the top layer of the cornea), may raise the risk of flap loss.


Recognising a Lost Flap

After undergoing LASIK, if you experience severe eye pain, haze, unpredictable changes in vision, light sensitivity, excessive tearing, or the feeling of something being in your eye, it is critical to seek the expertise of an ophthalmologist immediately. Flap loss can also lead to severe irregular astigmatism.


Treating a Lost LASIK Flap

Depending on when the loss is detected and the flap’s condition, treatments may involve:

  • Repositioning the Flap: If it’s intact and found promptly, your eye surgeon might be able to place it back onto the stroma. This can involve using stitches or special glue to secure the flap in place during the healing process.
  • Natural Healing: Sometimes, allowing the corneal surface to heal naturally may be safer than attempting flap replacement. The doctor may opt for bandage contact lenses until the cornea re-epithelializes. Medications might be prescribed to prevent infections and aid in the healing process. There’s often a need for a slow tapered schedule of topical steroids to prevent scarring.
  • Alternative Surgeries: Should the flap be deemed unsuitable or lost entirely, alternatives that can be considered:
    • PRK (Photorefractive Keratectomy). PRK reshapes the cornea using the excimer laser directly on the corneal surface, bypassing the need for a flap. It’s important to note that PRK entails a longer healing period and a higher risk of complications compared to LASIK.
    • Implantation of Lenses: Another viable option involves the surgical implantation of lenses within the eye.


Long-Term Outcomes and Recovery

The long-term visual outcomes following a LASIK flap loss can vary based on the treatment approach chosen:

  • Repositioned Flap: Successful repositioning could potentially restore vision to pre-surgical levels, but minor imperfections and residual haze in the central stroma may persist.
  • Natural Healing: Visual acuity post-surgery may not be as sharp as from a successful LASIK procedure. Patients may still require corrective eyewear for optimal vision, with a higher risk of corneal irregularities.


Preventing LASIK Flap Loss

Precautionary steps:

  • Follow post-op instructions carefully: Use prescribed eye drops, wear protective shields while sleeping, and avoid eye rubbing.
  • Avoid strenuous activities and sports for the first few weeks after surgery: This includes swimming, weightlifting, and activities risking eye trauma.
  • Protect eyes from dust, wind, and irritants: Wear sunglasses outdoors, especially in windy or dusty conditions.
  • Maintain good eye hygiene: Wash hands before touching eyes and avoid harsh soaps or cosmetics near eyes.
  • Attend all follow-up appointments with your ophthalmologist: Allow monitoring of healing progress and prompt concern resolution.


Living Through and Beyond the Complication

Losing a LASIK flap can undoubtedly be distressful. It is, however, manageable with experienced ophthalmologists on hand. Early intervention is key to a better outcome, and alternative procedures are available should they be necessary. It’s also crucial not to discount the emotional aspect of such an occurrence and to open up about any concerns with your healthcare provider.



While LASIK is predominantly a safe and efficient means of achieving clearer vision, any surgical procedure is not without its risks, including the rare event of a lost LASIK flap. Being informed about the possibilities allows for immediate action, which can significantly improve results following this unlikely complication. Ensuring vigilant follow-up care and knowing your treatment options are critical for successful recovery post-LASIK.

Remember, while this blog aims to inform, it does not substitute for professional medical advice. If you have concerns about your eyes post-LASIK, contact your eye care provider for guidance tailored to your specific situation.


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