Purpose: To describe improvements in surface ablation technique from 1993 to the present time in over 5000 eyes. These included 85 eyes with latent or manifest kerataconus and thin corneas.

Method: The author’s technique and results will be described. Advances during the evolution of the technique including topical and intra-operative mitomycin, post-excimer cool-pools and cruciform LASEK will be described.

Results: Excellent results were obtained with a low incidence of re-operations. Eyes with up to 17 dioptres of myopia, 6 dioptres of astigmatism and hyperopia up to 3.5 dioptres were treated.

Conclusion: Bilateral surface ablation is a safe and effective surgical modality with excellent long-term results as well as a high safety index with minimal post-operative discomfort. High risk LASIK eyes can be treated safely with surface ablation.

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