By Michael O'Keefe
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Extra resources for Current Understanding and New Techniques in Refractive Surgery
The main causes are an incomplete adhesion of the flap to the stromal bed, excessive eye dryness, rubbing movements by the patients or an accidental trauma to the flap during postoperative instillation therapy. For this reason it is very important to assess patients with a slit lamp before discharging them to check correct flap alignment, instruct them on how to apply postoperative drops, recommend that they not rub their eyes in the initial postoperative days and ask them to use sunglasses during the day and protective transparent cups when sleeping.
Laser epithelial keratomileusis for myopia. J. Refract. Surg. 2003 NovDec; 19(6): 666-70.  Liu XQ, Xu L, Yi CJ. Flap removal or flap preservation during LASEK surgery. Cell Biochem. Biophys. 2010 May; 57(1): 45-8.  Taneri S, Oehler S, Koch J, Azar D. Effect of repositioning or discarding the epithelial flap in laser-assisted subepithelial keratectomy and epithelial laser in situ keratomileusis. J. Cataract Refract. Surg. 2011 Oct; 37(10): 1832-46.  Kalyvianaki MI, Kymionis GD, Kounis GA, Panagopoulou SI, Grentzelos MA, Pallikaris IG.
26] Cui M, Chen XM, Lu P. Comparison of laser epithelial keratomileusis and photorefractive keratectomy for the correction of myopia: a meta-analysis. Chin. Med. J. ) 2008; 121(22): 2331-5.  Ghoreishi M, Attarzadeh H, Tavakoli M, Moini HA, Zandi A, Masjedi A, Rismanchian A. Alcohol-assisted versus Mechanical Epithelium Removal in Photorefractive Keratectomy. J. Ophthalmic Vis. Res. 2010 Oct; 5(4): 223-7.  Teus MA, de Benito-Llopis L, García-González M. Comparison of visual results between laser-assisted subepithelial keratectomy and epipolis laser in situ keratomileusis to correct myopia and myopic astigmatism.