An incision is made in the cornea (Fig 5). This corneal flap (Fig 6). is made using an instrument called a Microkeratome which lifts a thin surface layer of the cornea away from underlying layers. The middle layer of the cornea is thereby exposed for the laser treatment.

The surgeon focuses the laser on the exposed middle layer of the cornea. A foot pedal is depressed to activate the laser. The laser treatment usually lasts anywhere from a few seconds up to a minute, depending on the amount of correction needed (Fig 12). While the laser is running, it makes a rapid ticking sound. Each tick represents an individual pulse of the laser(Fig 13). After the laser reshapes the cornea, a small amount of fluid is used to wash away microscopic debris. The flap is then folded back into place (Fig 14). In a few minutes natural adhesive forces seal it in place without the need for sutures.