The most important factor in undertaking a refractive procedure is that we need to be within the stroma to make it comfortable to the patient. But, from a biomechanical standpoint, we need to be as superficial as we can. Also to decrease wound-healing complications, we must avoid any damage to the epithelium. That’s why, the switch over to thinner flaps. A new technique known as sub bowmans keratomileusis offers us more room for doing wider and deeper ablations and serves as a bridge between surface ablation and LASIK