What holds the flap in place after surgery?
There are four natural forces that cause a newly made corneal flap to re-adhere to the cornea: Tissues like to stick together. Within seconds hydrostatic forces between the flap and the corneal stroma create a seal between the two tissues, causing the flap to begin to re-adhere. Endothelial cells are constantly pumping fluid out of the cornea. This pump function maintains corneal clarity and creates a natural vacuum that holds the flap down. This process begins working in a matter of minutes. Within hours the epithelial cells grow over the edge of the flap. This process helps to glue down the flap and takes just a few days to complete. Eventually, the internal healing process allows for the flap to be permanently glued down. The corneal flap is most vulnerable during the first twelve to sixteen hours immediately after surgery. With each passing hour it grows more and more stable until it is fully re-adhered.
