Indications, techniques, results, limits, and complications of laser in situ keratomileusis

In this article we describe the state of the art of laser in situ keratomileusis (LASIK) through a presentation of the principles, the advantages, the disadvantages, the indications, the techniques, and the main complications. LASIK, as it is known today, involves the creation of a corneal flap using a keratome; this is followed by the in situ photoablation of the exposed stromal bed with an excimer laser. The flap thickness is about 160 mm with a circumference of about 300 degrees, the idea being to leave a portion of tissue attached, thus creating a corneal hinge. The in situ stromal bed exposed by the lamellar cut is then photoablated and the flap is repositioned without sutures. Functional recovery and anatomical healing are rapid. The operation is painless, and it is performed under topical anesthesia in an outpatient environment.