This video is a compilation of challenges faced during flap creation in LASIK surgery. The purpose of this video is to help refractive surgeons manage these complications well and provide an excellent visual outcome to all their patients. We have chosen four cases to demonstrate the flap related complications. Three patients underwent microkeratome LASIK. The management of flap tear, partial flap and free cap is discussed. During the femtosecond laser flap creation, we encountered air bubbles in the anterior chamber which interfered with pupil tracking. The difficulties faced during surgery and how to conquer them is well depicted. All the patients achieved uncorrected visual acuity of 20/20 at 6 months follow up. We conclude that, in order to achieve optimal visual outcome during LASIK surgery, we must recognize the flap related complication on time, provide a remedy wherever possible and reschedule the cases when necessary.
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