Intraocular Pressure–Based Corneal Remodeling Laser Surgery:LAREK (Laser Remodeling Keratectomy)A thin peripheral cornea predisposes both the anterior and posterior corneal surfacesto intraocular pressure (IOP)–driven deformation, leading to progressive cornealprotrusion. This biomechanical vulnerability contributes to irregular astigmatism, tearfilm instability, and corneal ectatic disorders such as keratoconus.Conventional treatment strategies typically combine customized laser refractivesurgery to flatten protruded regions with corneal cross-linking (CXL) to enhancecorneal stiffness. However, inadequate CXL may result in recurrent protrusion,whereas excessive CXL can cause corneal haze and visual impairment.Since the early 2000s, efforts have been made to modulate corneal biomechanics. In2015, we developed a novel laser surgical technique that leverages intraocularpressure (IOP) to restore and maintain a physiologic corneal configuration. Thistechnique, termed LAK and later LAREK, is currently applied clinically in Korea forkeratoconus remodeling, with outcomes reported in twelve peer-reviewedpublications.LAREK is a non-destructive and quantitative procedure that preserves the thinnestand most protruded corneal regions while selectively correcting thickness deviationin a centrally symmetric manner to enhance structural stability. The technique is safe,simple, and compatible with conventional treatments, including intracorneal ringsegments and FILI, producing synergistic effects in progressive keratoconus.