The procedure is done using eye drop anesthesia, and, while you may feel pressure, the technique is generally not painful. First, an instrument known as a microkeratome makes a protective flap in the outer layer of the cornea, at about twenty-five percent of its depth from the surface. Next, the excimer laser sculpts the internal corneal tissue to the correct refractive power in the “steep” axis by flattening the curvature of the exposed corneal tissue in that axis more than the other. Light rays are then more directly focused on the retina in both axis, thereby reducing the astigmatism. After a few minutes of drying, the corneal flap is laid back in its original position. Due to the cornea’s extraordinary natural bonding qualities, the flap seals on without sutures within two to five minutes. The surgery is performed on an out-patient basis and most people return to work within one to three days. As with any surgical procedure, individual results cannot be guaranteed and side effects and complications may occur.