Excimer laser refractive surgery is carried out under a partial-thickness lamellar corneal flap. The surgeon uses an instrument called a microkeratome to cut a thin flap of the corneal tissue. Then this corneal flap is lifted like a hinged door and the targeted tissue is removed with the excimer laser from the corneal stroma, again with the microkeratome, and finally the flap is replaced.
In 1963, the Colombian Ophthalmoligist Ignacio Barraquer developed the first proficient technique to refractive surgery, which was called keratomileusis which means corneal reshaping.
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