1. Suction ring:

After the eyelid is secured in the open position using a lid speculum, the eye is numbed using topical eye drops. The eye is then stabilized with a suction ring which fits snugly on the eye. This allows the cornea to protrude through the hole in preparation for the microkeratome . The arrow on the handle indicates the direction of the suction. You will not feel pain during this stage; however, vision may momentarily darken during the time the suction is applied.

After the eyelid is secured in the open position using a lid speculum, the eye is numbed using topical eye drops. The eye is then stabilized with a suction ring which fits snugly on the eye. This allows the cornea to protrude through the hole in preparation for the microkeratome . The arrow on the handle indicates the direction of the suction. You will not feel pain during this stage; however, vision may momentarily darken during the time the suction is applied.

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2. Microkeratome:

Next, the microkeratome is placed into the grooves on the ring and the gears are lined up. The microkeratome is similar to a carpenter's plane. It has a carefully measured footplate which controls the depth of the incision to about 1/4 of the corneal thickness. However, this "plane" is not pushed through the cornea by hand. There is a small motor in the handle which turns some gears causing the blade to oscillate rapidly as it passes through the cornea. Remarkably, there is no pain during this step. After the microkeratome has passed over the cornea a thin flap (F) is created with a "hinge." This hinge allows the flap to stay in the correct position after the laser ablation.

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3. LASER:

With the flap folded back, the excimer laser (L) removes an exact amount of tissue from the center of the cornea, achieving the prescribed flattening of the central cornea to reduce and hopefully eliminate myopia . A computer controls the amount of laser treatment based on your prescription. During this stage, your surgeon will watch to ensure that the laser is focused correctly. You will be asked to focus on a light during this stage of the procedure to allow for proper aiming of the laser. This is not difficult to do as the vision is adequate to see during this step.

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4. Flap Replacement:

Lastly, the flap (F) is returned to its original position with a manipulator (M) where it adheres tightly to the underlying tissue (stroma [S]). It is allowed to air dry for approximately 5 minutes. There is no need for sutures and it does not move, even with vigorous blinking.

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