Refractive Surgery
Eyes that no longer need to be managed.
Four laser techniques, one thorough assessment, a plan that fits your eyes and your life. Refractive surgery at Palazzo Manzoni in Brescia, with an ophthalmology department led by Dr. Andrea Russo.
Laser refractive surgery at Palazzo Manzoni in Brescia corrects myopia, hyperopia, astigmatism and early-to-moderate presbyopia with four Zeiss-based techniques: SMILE, Femto-LASIK, PRK and Presbyond. The ophthalmology department, led by Dr. Andrea Russo, MD, PhD, designs each laser plan around the patient’s eyes and life, not around a single default technique.
4 Techniques
SMILE, Femto-LASIK, PRK, Presbyond
Zeiss
Exclusive technology partner
1 specialist
From examination through recovery
Next day
Typical return to daily activity
The Discipline
You’ve been adapting for a long time.
Maybe the first thing you reach for in the morning is your glasses. Maybe your contact-lens kit travels with you everywhere. Maybe you’ve started holding your phone a little further from your face. None of it feels unusual anymore, which is its own kind of signal.
Most refractive errors don’t improve on their own. Presbyopia doesn’t pause. Each year is another year your eyes work around the problem instead of being corrected. Waiting isn’t neutral.
At Palazzo Manzoni in Brescia, the first step is simply a full diagnostic assessment, where we understand your eyes and your life before we recommend anything. It takes about an hour, and it commits you to nothing.
What Makes SMILE Different
A considered assessment, then the right procedure for your eyes
Laser vision correction only works well when the technique matches the eyes. That match is what the first examination is for. Not a sales conversation. A careful look at your prescription, corneal shape and thickness, tear film, and the way your vision fits into your life.
The department is led by Dr. Andrea Russo, MD, PhD, whose research, teaching and inventions in refractive surgery set the clinical standard the whole team works to.
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A plan built for your eyes
Each treatment plan is designed around your cornea, prescription and daily life, not around a single default technique.
02
Everything under one roof
Diagnostics, surgery and follow-up in a single location. No referrals, no waiting between facilities.
03
Precision technology
The department works with Zeiss diagnostic and laser systems throughout, currently the benchmark in refractive surgery.
04
Day surgery in a palazzo
Hospital-grade operating rooms inside a restored historic building that feels nothing like a hospital.
How It Works
Four laser techniques,
one decision
Laser vision correction isn’t a single procedure. Different techniques suit different eyes, and the right one for yours depends on your cornea, your prescription and your daily life, not on a default choice. Each has a place, and the differences matter.
Here’s how they compare. The choice is made with you, after your assessment.
Technique 01
SMILE
Best for
Myopia, hyperopia and associated astigmatism. Active lifestyles, dry-eye tendency, contact-sport athletes.
What it feels like
A single Zeiss femtosecond laser sculpts a thin lenticule inside your cornea and removes it through a 2 to 4 mm micro-incision. No flap. The laser delivery itself takes about two minutes per eye, inside a longer, carefully managed visit. Topical anaesthetic drops only.
Recovery
Most patients return to daily life the day after surgery, including exercise. Minimal post-operative dry eye compared to flap-based techniques.
Trade-offs
Does not correct presbyopia. Not suitable for every prescription: corneal thickness and diopter range set the limits.
Technique 02
Femto-LASIK
Best for
The full range of distance-vision corrections: myopia, hyperopia and astigmatism.
What it feels like
A Zeiss femtosecond laser creates a thin corneal flap. A Zeiss excimer laser reshapes the underlying cornea to your exact prescription. The flap is repositioned and seals naturally. The laser delivery itself takes about two minutes per eye, inside a longer, carefully managed visit. Topical anaesthetic drops only.
Recovery
Clear vision within hours. Most patients return to work and driving the next day.
Trade-offs
Requires sufficient corneal thickness. Mild, short-term dry-eye sensation is common in the first weeks.
Technique 03
PRK
Best for
Thin corneas, contact-sport and combat athletes, certain professional requirements, and therapeutic cases where the corneal surface itself needs to be addressed.
What it feels like
No flap. The thin surface layer of the cornea is gently removed and the excimer laser reshapes the corneal surface directly. The laser delivery itself takes about five minutes per eye, inside a longer, carefully managed visit. A protective contact lens is worn for the first few days.
Recovery
Slower than SMILE or Femto-LASIK. Expect 5 to 10 days of blurred vision and some discomfort, with visual stability developing over three to four weeks.
Trade-offs
More post-operative discomfort than flap-based or flapless techniques. In return, a robust, well-studied result with decades of evidence behind it.
Technique 04
Presbyond
Best for
Patients in their forties and early fifties with early-to-moderate presbyopia who want to avoid or delay lens-based surgery. Often combined with correction of myopia, hyperopia or astigmatism in the same treatment.
What it feels like
A Zeiss femtosecond and excimer laser combination, programmed to create a blended vision profile across both eyes. One eye is set slightly for distance, the other slightly for near, with a deliberate overlap in between. Unlike older monovision approaches, the visual fields blend naturally, so the brain uses both eyes together. Most patients adapt within days.
Recovery
Similar to Femto-LASIK. Most patients return to daily life within one to two days.
Trade-offs
The window is age-bounded. Presbyond works best before the eye’s natural lens begins to cloud. For later-stage presbyopia or early cataract, premium multifocal lens implantation is usually the better answer.
Which one is yours?
That’s what the assessment is for.
An unhurried process, designed around you
From first visit
to clear vision.
Step 01
The assessment
About an hour. A thorough diagnostic examination, a conversation about your daily life and visual goals, and a clear explanation of the techniques appropriate for your eyes. You leave with clarity, not with a decision pushed on you.
Step 02
The day of surgery
You’re welcomed, you change into surgical wear, anaesthetic drops go in. The laser itself takes between two and five minutes per eye. You’re awake, comfortable, talked through every step. You go home the same day.
Step 03
The first 24 hours
Rest, a light evening, sleep. A gritty sensation or mild watering in the first hours is normal and fades. For SMILE, Femto-LASIK and Presbyond, most people wake up the next morning and simply see. PRK takes longer, and your specialist will prepare you.
Step 04
The weeks that follow
Follow-up visits the next day, at one week, one month, and three to six months. Your specialist confirms your eyes are healing as expected. You have direct access to the team throughout.
What life looks like after
The small things first,
and then everything else
The morning without reaching. Night driving without the small halo around contacts. A menu read without the small adjustment. A book picked up without searching for the second pair of glasses.
In their own words
I’d worn contacts for twelve years. The day after surgery I went to the office and forgot about my eyes for the first time I can remember. That forgetting, that’s the part I hadn’t expected.
Swimming with my kids without worrying about contacts. Reading the car dashboard at night without a halo. Small things, except they weren’t small before.
My prescription was fine for laser, but my job isn’t fine with anything that can dislodge. My specialist recommended PRK. The first week was real, and then it was done. Two years later, perfect.
I didn’t want lens surgery. I wanted to read a menu without reaching into my pocket. Presbyond gave me that, and it gave me my distance back too. I can’t remember the last time I thought about my eyes.
Who Leads the Department
Dr. Andrea Russo
Ophthalmologist. Founder of Palazzo Manzoni. Specialist in laser refractive surgery, ICL and cataract surgery.
International surgical training
including Moorfields Eye Hospital, London
Academic research and teaching
research fellow at the University of Brescia, 1,200+ peer-reviewed citations
Professional societies
fellow of the World College of Refractive Surgery (FWCRS), member of the American-European Congress of Ophthalmic Surgery (AECOS) and the European Society of Cataract and Refractive Surgeons (ESCRS)
Inventor
creator of D-Eye, a smartphone-based retinal imaging device used in clinical practice worldwide
15,000+
procedures performed
“Every pair of eyes tells a different story. Our role is to understand yours fully, explore every option that could improve your vision, and guide you with confidence toward the one that fits your life best.”
Options
If laser isn’t right, that’s not the end of the story
Some corneas are too thin for any laser. Some prescriptions sit beyond what a laser can reach. And for some eyes, the natural lens is already the better place to correct vision.
Being told “no” to laser is not the end of your vision story. It usually means a different kind of correction fits your eyes better.
→ICL lens implantation
For prescriptions too high for laser, or corneas too thin for any corneal technique. No corneal tissue is removed.
→Premium and multifocal lenses
For eyes where the natural lens is already clouding, or presbyopia has moved past what a laser can address.
Your assessment will clarify which path is right.
Common Questions
Common questions
about ophthalmology
What vision problems can be treated at Palazzo Manzoni?
The ophthalmology department treats the full range of refractive errors (myopia, hyperopia, astigmatism, presbyopia) and cataracts. Treatments include laser refractive surgery (SMILE, Femto-LASIK, PRK, Presbyond), ICL phakic lens implantation for high or unusual prescriptions, and cataract surgery with standard or premium multifocal lenses.
How do I know which treatment is right for me?
That is exactly what your first eye examination is for. It assesses your prescription, corneal shape and thickness, lens clarity, and overall eye health, then places those findings in the context of your age, lifestyle, and visual goals. You leave with a clear explanation of your options and an honest recommendation, not a sales pitch.
Am I a candidate for laser vision correction?
Most patients between 20 and 45 with stable myopia, hyperopia, or astigmatism are good candidates. The pre-operative examination looks at corneal thickness, prescription stability, and eye health to confirm suitability. If laser is not ideal for you, ICL lens implantation is often an excellent alternative.
What if another clinic told me surgery isn’t an option for me?
It is worth a second opinion. High prescriptions, thin corneas, or unusual anatomies often rule out standard laser surgery, but do not rule out vision correction. Patients in this situation are frequently successful candidates for ICL, a phakic intraocular lens implanted without removing corneal tissue.
What is the difference between standard and premium lenses for cataract surgery?
A standard intraocular lens restores clear distance vision after cataract removal, but you will still need reading glasses for close-up tasks. A premium multifocal lens corrects distance, intermediate, and near vision in the same surgery, reducing or eliminating dependence on glasses. The right choice depends on your lifestyle.
What happens during my first eye examination?
Your first visit lasts about an hour. It includes a detailed diagnostic examination with advanced imaging, a discussion of your vision goals and daily life, and a personalized explanation of the treatment options available to you. There is no pressure to decide anything during the visit. You leave with the information you need to make a calm, informed choice on your own timeline.
Is the procedure painful, and how long does recovery take?
Procedures are performed under local anaesthetic eye drops, so you feel no pain, only light pressure. Most laser patients see improvement within hours and return to normal activities within one to two days. Cataract patients typically see clearly by the next day. Full visual stabilization can take a few weeks depending on the procedure.
How much does treatment cost?
Costs depend on the procedure and, for cataract surgery, on the type of lens chosen. After your initial examination, once the appropriate treatment has been identified, you receive a detailed, transparent cost estimate with no hidden fees.
Where is Palazzo Manzoni located, and do I need a referral?
Istituto Chirurgico Palazzo Manzoni is at Via dei Mille 14 in central Brescia, easily reached by car or public transport from anywhere in Lombardy, including Milan (about one hour away). No referral is required. You can book directly by phone, email, or online form.
Who leads the ophthalmology department?
The ophthalmology department is led by Dr. Andrea Russo, MD, PhD, ophthalmologist, researcher, and founder of Palazzo Manzoni. Dr. Russo specializes in laser refractive surgery, ICL lens implantation, and cataract surgery with premium IOLs, and collaborates with the University of Brescia. His research on refractive surgery and ocular imaging is internationally cited.
Take the Next Step
Your next step starts
with a conversation
At Palazzo Manzoni in Brescia, every consultation is personal, unhurried, and designed to give you clarity about your next step.
Address
Via dei Mille 14, 25122 Brescia, Italia
Phone
Hours
Mon-Fri 8:30-18:30 · Sat 9:00-13:00
01
Get in touch
Call, email, WhatsApp, or book online.
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Meet your specialist
A personal consultation to understand your situation.
03
Your plan, your pace
Together you decide the best path forward.
Scientific research
The Institute’s surgeons contribute to international research. Dr. Andrea Russo’s work includes a study on the SMILE technique published in Scientific Reports, Nature group (2026), one on artificial intelligence applied to ICL lenses in the Journal of Cataract & Refractive Surgery (2023), and a comparison of 484 eyes after LASIK and PRK in Ophthalmology and Therapy (2021). The team’s full list of publications is available on PubMed.
Content reviewed by Dr. Andrea Russo and Dr. Pierdavide Perrini, refractive surgeons at the Institute.