The patient will remain fully awake throughout the procedure and lies down for the surgery.  A sedative is often used to keep the patient calm and anesthetic eye drops numb the eyes.  For the first eye, a special type of retainer is placed over the eye to keep the eyelids open.  The retainer includes a suction ring that aids in keeping the eyelids open.  This aids the surgeon in cutting the corneal flap and is not uncomfortable to the patient.  The surgeon then uses lasers to make incisions in the cornea.  The computer system tracks the patient’s eye position so that precise incisions are made.

Using a blade or femtosecond laser, the surgeon then cuts a flap in the cornea.  The cornea is hinged on one end.  The flap of the lining is pulled back to uncover the stroma of the cornea.  This is the middle portion of the cornea.  Using an excimer laser, the surgeon then reconfigures the corneal stroma by vaporizing unnecessary tissue.  The procedure does not damage the stroma.  The laser uses cool ultraviolet light rays to remove very small pieces of tissue.  The doctor removes more or less tissue depending on the severity of the vision problem.  Some patients only need a small amount of removed. 

After the corneal tissue is removed, the surgeon reshapes the cornea.  As this procedure occurs, the patient hears a clicking sound.  This is simply the laser running.  You may also smell a mild and acrid scent.  This is the smell of the tissue being removed.  This procedure causes the cornea to focus better and improves vision.  The flap is then placed back over the area and allowed to heal.  The length of the procedure depends on how poor the patient’s vision is.