Free flaps that happen consecutively to microkeratome use are a dreadful complication. Many times, this ends in an unpredictable refraction, especially if the cornea is affected by corneal astigmatism. In this chapter, we describe the main issues to take into consideration to prevent this complication and also how to solve it in those cases in which it might appear. Free flap creation has become rare with the use of femtosecond laser but it is still feasible especially in the learning curve of refractive surgeons.