The aim of this review is to summarize the key components for both the microkeratome and the femtosecond laser and to update on the recent advances reported on these topics.

The data presented here should aid surgeons in understanding the effects of currently available LASIK treatment profiles. Surgeons should also be able to appreciate how the findings were used to create a decision tree to help choose the most appropriate treatment profile for patients. Finally, the retrospective evaluation of clinical outcomes based on the decision tree should provide surgeons with a realistic expectation for their own outcomes should they adopt such a decision tree in their own practice.

LASIK with the ALLEGRETTO WAVE 200- and 400-Hz laser is effective and predictable for the treatment of high myopia with astigmatism in appropriately selected patients. The acuity and predictability of refractive results may be slightly better when using the 400-Hz platform.

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I ntroduction:The design of the study was to look consecutively at what are the prime influences on enhancements in laser vision correction related to the perioperative environment. Methods: A prospective consecutive series of 4,079 cases was reviewed from a single surgeon at a single surgical site. Patients were followed prospectively and were only included after at least two years of postoperative follow-up. Results: The series ranged in primary treatments of spherical equivalents (SE) from 0 to -12 diopters (D) with up to 4 D of cylinder. The preoperative average SE was -4.59±2.79 D and the cylinder average was -0.90±0.90 D. Uncorrected visual acuity (UCVA) prior to the enhancement was 0.63±0.23 (20/32) and post-enhancement was 0. 99±0.20 (20/20). The top four influences on enhancements were presence of an opaque bubble layer (31.00%); dry eye disease (27.60%); history of ocular allergy (24.10%); and poor fixation (17.10%). Patients could have more than one of the above influences. Conclusions: Laser platforms, outcomes analysis, nomograms, and other influences will be discussed to help produce enhancement rates below 1.00%, which for this series was 0.71% overall. KeywordsLaser in situ keratomeilusis (LASIK), enhancement rates, opaque bubble layer, dry eye disease, ocular allergy Disclosure: Megan Stonecipher has nothing to disclose in relation to this article. Karl Stonecipher is a speaker, consultant and researcher for the following companies: Abbott Medical Optics, Alcon, Allergan, Alphaeon, Bausch and Lomb, Laser Defined Vision, Nidek, Physicians Protocol, Presbia, Refocus, Shire, TLC. No funding was received in the publication of this article.Compliance with Ethics: All procedures were followed in accordance with the responsible committee on human experimentation and with the Helsinki Declaration of 1975 and subsequent revisions, and informed consent was received from the patient involved in this study. The design of the study was to look at the prime influences on enhancements in laser in situ keratomeilusis in a prospective fashion from one surgeon at one center with control of as many variables as possible.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any noncommercial use, distribution, adaptation, and reproduction provided the original author(s) and source are given appropriate credit. This research is primarily focused on the influences on enhancements in laser vision correction during the perioperative period. As surgeons we always strive to enhance technology while trying to improve outcomes. However, this study was a prospective look at what influences enhancement rates from a surgical technique, an intraoperative suite, or associated findings in patients. This study focused on associated influences in patients treated. The study group included a total of 4,079 consecutive cases, with 29 cases requiring enhancements (see Figure 1). The data for this study were prospectively collected from 2011 to 2013 and analyzed after at lea...