Laser in situ keratomileusis with microkeratome or femtosecond laser

Objective and principles. In LASIK, after cutting a lamellating stromal corneal incision (flap) with a microkeratome or a femtosecond laser, the underlying tissue is treated with an excimer laser for refractive correction. The objective is to achieve independency from spectacles and contact lenses due to correction of ametropia. Indications. Surgery is indicated when the patient wishes to achieve independency from spectacles and contact lenses. For LASIK, the German Commission for Refractive Surgery defined a range of applicability for myopic correction up to -8 diopters (D), astigmatic correction up to 5 D and hyperopic correction up to + 3 D. Borderline applicability is defined as myopic correction up to -10 D, astigmatic correction up to 6 D and hyperopic correction up to + 4 D. Operative technique. The surgical technique is demonstrated in detail with the help of a video of the operation, which is available online. The flap incision is created with a microkeratome or a femtosecond laser. After lifting and folding the flap, excimer ablation is performed. An eye tracking system ensures correct location of ablation by compensating for intraoperative eye movements. After repositioning the flap, the interface is irrigated and the edge of the flap is adapted with a sponge. Results. The LASIK procedure is safe, predictable and efficient with a high rate of patient satisfaction. The complication rate can be minimized by using a careful and standardized surgical approach.