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Written and reviewed by Dr Gozlan, ophthalmic surgeon · 29 October 2026 5 min read
Illustration of a cross-section of the eye: light rays pass through the cornea and the lens and converge on the retina

What is refractive surgery? Principles, techniques and steps

Dr Gozlan
Dr Gozlan
Ophthalmic surgeon – refractive surgery

Have you heard about "eye surgery" or "laser eye surgery" as a way to rely less on your glasses? The medical term is refractive surgery. But what is refractive surgery, exactly? This article gives its definition, explains its principle, presents the main families of techniques and describes the usual steps, from the pre-operative assessment to follow-up.

Refractive surgery: the definition

Refractive surgery refers to all procedures that correct refractive errors, i.e. the optical errors of the eye: myopia, hyperopia, astigmatism or presbyopia. According to the American Academy of Ophthalmology (AAO), these procedures all share the same goal: focusing light correctly on the retina so that you can see more clearly.

In everyday language, people often talk about laser eye surgery or an eye laser. These expressions usually refer to laser techniques on the cornea, but refractive surgery also includes techniques that use an implant placed inside the eye.

The principle: reshaping the cornea or adding a lens

For an image to be sharp, light rays must focus precisely on the retina, at the back of the eye. In a short-sighted eye they focus in front of the retina; in a long-sighted eye, behind it; with astigmatism, the cornea does not bend light in the same way in every direction.

The AAO distinguishes two main approaches:

The main families of techniques

According to the AAO, the most common refractive surgery is LASIK; PRK and SMILE are also among the common procedures:

These techniques have been compared in Cochrane reviews, for example LASIK and PRK or laser surgery and implants for moderate to high myopia. These reviews describe general differences between techniques, not a rule that applies to every eye. The laser techniques performed by Dr Gozlan are presented on the Techniques page, and their differences in the article LASIK or PRK: what are the differences?

Who decides on the technique?

The technique is not the patient's choice. Dr Gozlan, ophthalmic surgeon, determines it after the pre-operative assessment, based on the examinations: thickness and shape of the cornea, correction needed, age, condition of the eye surface and lifestyle. He explains the technique selected, its expected benefits and its possible risks.

The AAO points out that there is no single best method for everyone and that, sometimes, it is preferable to keep your glasses or contact lenses. If no surgery is suitable for your eyes, the surgeon will tell you.

The steps: from assessment to follow-up

Whatever the technique, the pathway usually has three steps:

Myopia surgery is considered from the age of 18, with stable myopia. The general criteria are detailed in the article Am I a candidate for myopia surgery? Fees are listed on the Fees page.

What refractive surgery can do, and its limits

The aim of refractive surgery is to reduce dependence on glasses and contact lenses. It is not a guarantee: the AAO stresses that you must accept the risks and possible side effects of surgery, and understand that you may still need glasses or contact lenses to see your best.

The outcome depends on each eye. That is why the ophthalmic surgeon takes the time, during the consultation, to explain what can reasonably be expected in your case.

FAQ: what is refractive surgery?

What is refractive surgery, in one sentence?

It is the set of procedures that correct the optical errors of the eye (myopia, hyperopia, astigmatism, presbyopia), by reshaping the cornea with a laser or by placing a lens inside the eye.

Are "laser eye surgery" and refractive surgery the same thing?

Almost: laser eye surgery, sometimes called "eye laser", is the best-known form of refractive surgery. But refractive surgery also includes implant-based techniques, with no laser on the cornea.

Which vision problems can refractive surgery correct?

According to the AAO, myopia, hyperopia, astigmatism and presbyopia. Whether a correction is possible, and with which technique, depends on the assessment of each eye.

Who decides between LASIK, PRK or an implant?

The ophthalmic surgeon, after the pre-operative assessment and based on the examinations. He explains his reasons, the expected benefits and the possible risks.

Will I still need glasses after refractive surgery?

The aim is to reduce dependence on glasses and contact lenses, with no promise of results. The AAO points out that you may still need glasses or contact lenses to see your best.

Further reading

Sources