Refractive ophthalmic surgery allows refractive errors to be corrected permanently in a safe, effective, and reliable way with few complications.Selective literature review with special reference to the guidelines of the German Commission for Refractive Surgery.With a total of almost 18 million treatments performed to date, laser in-situ keratomileusis (LASIK) is the most commonly used refractive surgical procedure worldwide. Alternatives to LASIK include surface ablation procedures (PRK, LASEK, Epi-LASIK) and phakic intraocular lens implantation. If ocular accommodation is lost, removal of the crystalline lens and implantation of modern multifocal intraocular lenses (refractive lens exchange) provide an alternative means of correcting myopia, hyperopia and presbyopia.The treatment effect is maximized and complications kept to a minimum if strict inclusion criteria are applied and a high technical standard maintained during the procedure.