How laser vision correction works
The cornea is the clear front window of the eye, and its shape has a major influence on the eye's focusing power. In laser vision correction, the cornea is reshaped to reduce the refractive error: in myopia it is flattened, in hyperopia its curvature is adjusted to increase focusing power, and in astigmatism it is reshaped more in one meridian than another.
Explore the eye
Tap each of the five numbered points to understand where each laser technique works – the corneal surface, the flap, the lenticule – and why reading glasses may still come with age. All five points must be viewed.
Laser vision correction can treat short-sightedness, long-sightedness, and astigmatism, depending on the individual eye, corneal thickness, corneal shape, prescription, age, visual needs, and medical suitability. It has been performed successfully for decades. However, it is still surgery on a delicate optical structure: no surgical result can be guaranteed, and glasses, contact lenses, enhancement treatment, or other procedures may still be necessary in some cases. Importantly, the procedure does not stop the natural ageing of the eye – from around the mid-forties, most people develop presbyopia and near vision becomes weaker.
The three procedures
Each technique has specific advantages, limitations, recovery patterns, and risks. The best procedure is selected individually after detailed examination. Click all three cards.
Femto-LASIK Flap-based
A thin corneal flap is created with a femtosecond laser; an excimer laser reshapes the tissue underneath; the flap is repositioned without stitches.
Usually provides fast visual recovery – many patients see much better within one or two days. Mild dryness, foreign body sensation, fluctuating vision, glare, or light sensitivity can occur during healing. Suitable with sufficient corneal thickness, regular corneal shape, stable refraction, and an appropriate prescription range.
Advantages
- Fast visual recovery, usually little discomfort
- High accuracy in suitable eyes
- Well-established technique
- Treats myopia, hyperopia, and astigmatism
- Enhancement possible in many cases if enough tissue remains
Limitations
- Creation of a corneal flap
- Temporary weakening of corneal biomechanics
- Risk of flap-related complications
- Possible dry eye symptoms
- Not suitable for every cornea or prescription
CLEAR Lenticule
No flap: a femtosecond laser creates a thin lenticule inside the cornea, which is removed through a small incision.
Removing the lenticule changes the corneal shape and corrects the refractive error. Mainly used for myopia and astigmatism, depending on the treatment range and individual suitability.
Advantages
- No large corneal flap, only a small incision
- Potentially less disruption of corneal surface nerves
- Good biomechanical stability compared with flap-based procedures
- Usually comfortable healing
Limitations
- Visual recovery sometimes slightly slower or more variable than Femto-LASIK
- Enhancement options can be more complex than after LASIK
- Currently less suitable for certain hyperopic corrections
- Dry eye, glare, halos, residual error, or regression can still occur
PRK Surface
The superficial corneal skin layer (epithelium) is removed; the excimer laser reshapes the surface; a bandage contact lens protects the eye while the epithelium heals.
No flap is created – useful in selected patients with thinner corneas, higher trauma risk, certain occupational requirements, or eyes where a flap-based procedure is not ideal.
Advantages
- No corneal flap – avoids flap-related complications
- Useful in selected thinner corneas
- Well-established long-term procedure
- Suitable for selected patients where LASIK or CLEAR is not recommended
Limitations
- Slower visual recovery than Femto-LASIK
- More discomfort during the first days
- Bandage contact lens and longer use of drops
- Possible haze formation, greater dependence on wound healing
- Final stability may take several weeks to months
Choosing the right procedure
There is no single best procedure for every patient. The choice depends on prescription, corneal thickness, topography and tomography, tear film and dry eye status, pupil size, age, profession and hobbies, contact sports or trauma risk, previous eye surgery, expectations regarding recovery speed, risk tolerance, enhancement possibilities, and long-term corneal safety. In some cases, laser vision correction may not be recommended at all – alternatives include glasses, contact lenses, ICL/IPCL implantation, refractive lens exchange, or no surgery.
Before surgery: assessment & your information duties
Detailed measurements are required: refraction (with cycloplegia if needed), corneal topography and tomography, corneal thickness, pupil size, tear film and dry eye evaluation, retinal examination if indicated, and higher-order aberrations in selected cases. Contact lenses temporarily change the corneal shape and may need to be stopped before the final measurements, according to the clinic's instructions.
Please inform your doctor about any eye disease, systemic disease, medication, autoimmune disease, pregnancy or breastfeeding, previous herpes eye infection, keloid tendency, or previous eye surgery.
What you can realistically expect
Click all three cards – they cover the outcome, the possibility of a second treatment, and the effect of ageing.
Expected outcome Goal
Most suitable patients achieve very good uncorrected vision.
The aim is to reduce dependence on glasses or contact lenses. However, perfect vision without glasses cannot be guaranteed. Some patients may still need glasses for night driving, reading, fine work, computer use, or certain visual tasks. The final result depends on the preoperative prescription, corneal healing, tear film, pupil size, ocular surface, and individual biological response.
Laser correction does not create a perfect or "supernormal" eye – the goal is a meaningful improvement in unaided vision, not a guarantee of perfect vision under all conditions.
Enhancement ≈ 2–5 %
In some cases, a second laser treatment (retreatment) may be required.
The approximate enhancement rate is often in the range of 2 to 5 percent, depending on prescription, technique, healing response, age, dry eye, and other factors. Needing an enhancement does not automatically mean the eye was measured or treated incorrectly – even with careful planning, some eyes heal differently from the expected average.
Reasons include residual short-/long-sightedness or astigmatism, regression, individual healing, epithelial remodelling, dry eye, high preoperative prescription, or corneal biomechanics. Enhancement is only possible if the eye is suitable and enough safe corneal tissue remains; it may be performed as flap lift, surface treatment, PRK, or another technique. In some cases enhancement may not be recommended – glasses or contact lenses may then be the safer option.
Presbyopia From mid-40s
Laser correction does not stop the natural ageing of the eye.
From around the mid-forties, the natural lens loses flexibility (presbyopia) and near vision becomes weaker. A patient with excellent distance vision after laser correction may still need reading glasses later in life – this is not a failure of the treatment, but a normal age-related change.
Options such as monovision or blended vision may be discussed in selected patients, but they are not suitable for everyone and may affect depth perception or night vision.
Possible risks and complications
Laser vision correction is usually very successful – but as elective surgery on the eye, every risk must be known to you. Open every single item and confirm it with the button inside. Your consent is only valid once all items have been confirmed as read.
Medication, follow-up, and behaviour after surgery
After surgery, eye drops must be used exactly as prescribed – these may include antibiotics, anti-inflammatory or steroid drops, and lubricants. Do not stop or change medication without medical advice. Follow-up visits monitor healing, visual recovery, intraocular pressure, corneal clarity, epithelial healing, flap position (if applicable), and refractive stability. The exact restrictions differ depending on whether Femto-LASIK, CLEAR, or PRK was performed.
Avoid in the early period
- Rubbing the eyes
- Swimming pools and sauna
- Eye make-up for the recommended period
- Dusty or dirty environments
- Direct trauma to the eyes
- Stopping or changing drops on your own
Please do
- Use eye drops exactly as prescribed
- Protect the eyes from trauma
- Use sunglasses if light sensitive
- Attend all follow-up appointments
- Contact the clinic urgently if symptoms worsen
Alternatives to laser vision correction
Each option has its own advantages, limitations, and risks:
Did you understand everything? – Quick check
Three short questions – all three must be answered before the consent section unlocks.
1. Does laser vision correction prevent the need for reading glasses with age?
2. What does an enhancement (second treatment) mean?
3. What is the main difference between the three procedures?
Your declaration of consent
Before you can sign, the following must be completed:
- Eye diagram: all 5 points viewed (0/5)
- Procedures: all 3 technique cards opened (0/3)
- Expectations: all 3 cards opened (0/3)
- Risks: all items opened and confirmed (0/0)
- Comprehension check: all 3 questions answered (0/3)
The informed consent is not valid until every item above has been clicked and confirmed.