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The patient will be put under a local anaesthetic in the form of eye drops. A soft suction ring is applied to the eye to keep it in place. This can sometimes cause the small blood vessels within the eye to burst, resulting in some bleeding (or subconjunctival haemorrhage) within the white of the eye. This is harmless and should resolve within several weeks.  
Once the eye is immobilised, either a microkeratome or a femtosecond laser will be used to cut a thin flap in the cornea. Folding back and lifting the corneal flap can sometimes be uncomfortable, although the process is relatively quick. This flap will then be peeled back and then a 193nm excimer laser will be used to remove microscopic amounts of corneal tissue, or in the case of astigmatism, to smooth out an irregularly-textured cornea. The laser vaporises the tissue from the cornea without causing any damage to adjacent tissue. Burning or cutting of tissue is not required to remove and smooth out the corneal tissue. 
Once the corneal flap is lifted, the patient's vision will become blurry and they will only be able to see white light surrounding the orange light of the laser. This can lead to mild disorientation as the patient is unable to see. 
Once the laser has reshaped the stromal layer, the corneal flap is gently pushed into place. The surgeon checks the area for the presence of air bubbles and debris and checks to determine proper fit on the eye. Natural adhesion will keep the corneal flap in place until it heals. 
The whole process takes less than 10 minutes for one eye and less than fifteen minutes for both.

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