DR M. Gordon’s technique involves creating the flap with the Intralase using a hinge position that changes relative to the astigmatism being treated. Generally he aims for a 9-9.5 mm flap, a 70 degree hinge angle, a 60 degree side cut angle, and the thinnest flap the machine will allow, typically 90 microns. This is ideal in situations such as phakic IOLs where one may want to create the potential flap for fine tuning the refraction at a later date, after the IOL has been implanted. Gordon use a Slade spatula in one motion to lift the flap, it inserted near the hinge, dissecting the flap to the opposite side, and then wiggling the spatula away from the hinge. He finds not necessary to go halfway, complete the pass, and then go back and do the other half, but he prefers complete the flap maneuver in one pass. He still marks the edges of the flap with an old RK marker in two spots. This practice use two Excimer lasers, the Visx S4 with IR, and the Wavelight Allegretto. The combining of these two technologies has reduce the enhancement rate to 2% or less, and our patient satisfaction to an extremely high level. Typically in post-RK-patients he uses a 160–180 micron flap and sweeps one half the flap at a time to try and stay parallel to the incisions as to create minimum stress on the individual incisions. Another pearl is to avoid LASIK and switch to surface treatment if the incisions exhibit any epithelial cell (usualy noted by wide incisions).