Refractive Surgery
Eyes that no longer need to be managed.
A flapless technique with decades of evidence behind it — particularly suited to thin corneas, contact-sport athletes and patients with specific professional requirements. 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.
No flap
Surface ablation, no corneal flap
Zeiss
Exclusive technology partner
1 specialist
From examination through recovery
Days to weeks
Visual recovery window
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 PRK Different
The difference is the surface itself
Flap-based laser techniques cut a thin, hinged flap in the cornea to access the tissue underneath. The flap heals, the result is excellent, and for most patients the flap simply becomes irrelevant. But for as long as your eyes exist, it remains an interface. In contact sports, in combat roles, in rare accidental trauma, that interface can matter.
PRK removes the flap from the equation. The thin epithelial surface of the cornea is gently set aside and the excimer laser reshapes the corneal surface directly. No flap is cut, no lenticule is removed. The deeper structure of the cornea is left undisturbed.
Three things follow from that. The cornea keeps more of its natural biomechanical strength, with no flap interface in the long term. The technique is the most-studied refractive procedure in the world, with thirty-plus years of outcome data. And for the eyes that suit it — particularly thinner corneas — PRK gives a result that is exceptionally stable over time.
01
No flap, ever
The cornea’s deeper structure is left undisturbed.
02
Decades of evidence
Thirty-plus years of outcome data informs each plan.
03
One department, one pathway
Diagnostics, treatment and aftercare, led by Dr. Andrea Russo.
Step by Step
What happens during your PRK procedure, minute by minute.
Step 01
The surface is prepared
Anaesthetic drops, then the thin epithelial surface of the cornea is gently removed by the surgeon. You feel pressure, not pain.
Step 02
The laser reshapes the cornea
A Zeiss excimer laser sculpts your prescription directly into the corneal surface. About five minutes per eye, talked through at every step.
Step 03
A protective lens is placed
A clear bandage contact lens shields the cornea while the surface regrows. It stays in for the first few days, then your specialist removes it.
Step 04
You go home
A short rest at the clinic, then home the same day. The next 24 hours are quiet, with drops on a schedule.
Is PRK Right for Your Eyes?
Is PRK
right for your eyes?
PRK is not a universal laser. It is a specific answer for a specific clinical profile — particularly thinner corneas and patients who cannot accept a flap. At Palazzo Manzoni, most PRK candidates share several of the following.
Clinical profile
- Myopia approximately -1 to -6 dioptres, hyperopia and astigmatism within PRK’s clinical range
- Astigmatism up to approximately -3 dioptres, evaluated individually
- A stable prescription for at least 12 months
- Thinner corneas where flap-based techniques are not appropriate
- Age 21 or older, where the eye has usually completed refractive growth
- No active eye disease, uncontrolled inflammation or untreated severe dry eye
Life profile
- An active lifestyle such as running, cycling, climbing, swimming or skiing
- Contact sports and combat athletes where any flap is unacceptable — boxing, martial arts, rugby, water polo
- Military, law enforcement and emergency-response roles where regulations or duty prohibit flap-based correction
- A stable ocular surface, with any dry eye managed before surgery
- A willingness to accept a slower, more demanding recovery in exchange for surface stability and the longest evidence base
Where PRK isn’t the right answer?
PRK does not correct presbyopia, and it does not treat very high myopic prescriptions beyond approximately -6 dioptres. A schedule that cannot accommodate a 5 to 10 day visual recovery window is usually better served by a different technique. Your assessment at Palazzo Manzoni will identify which one.
If PRK fits, your assessment will confirm it. If not, the right answer for your eyes still exists, and the assessment will find it.
More Than a Decade of Evidence
More than a decade of evidence, on the original platform
PRK is one of the most-studied refractive procedures in the world, performed for over thirty years on Zeiss excimer laser platforms. At Palazzo Manzoni, PRK runs on the current-generation Zeiss system, with a clinical evidence base built across millions of procedures and decades of peer-reviewed research.
At Palazzo Manzoni, the entire refractive pathway sits on Zeiss systems, from preoperative imaging to follow-up measurements. What varies between clinics is not the technology. It is the experience of the team running it.
Day by Day
The first week, the first month, and the longer view
The first 48 hours
Rest, drops on a schedule, mild discomfort. The protective contact lens stays in place. Vision is hazy and that’s expected.
Days 3 to 5
The epithelial surface regrows. Your specialist removes the protective lens. Vision is still settling — patience matters here.
The first month
Vision sharpens progressively. Most patients return to work within 7 to 14 days, with sport later. Drops continue per plan.
Three months
Routine follow-up. Vision usually stable enough for daily life and sport. The team remains directly accessible.
6 to 12 months
Final follow-up. Your specialist confirms full healing and a stable result. PRK’s long-term stability is one of its quietest strengths.
Honest Trade-offs
What PRK
doesn’t do
Every laser has its trade-offs, and honesty about them matters more than marketing.
PRK is not the right answer for anyone who needs a fast visual recovery. The first few days are blurred and uncomfortable, and useful vision typically takes one to two weeks to settle, with fine detail continuing to refine for months. For schedules that demand same-week sharpness, SMILE or Femto-LASIK are usually better suited.
PRK, like any surgical procedure, is not risk-free. Serious complications are rare, well below 1 percent in the current literature, but they exist. The more common post-operative experiences are temporary dry-eye sensation, mild night-vision halos during the first weeks, and, in a small minority, a residual refractive error or corneal haze that can usually be managed. Rarer but real risks include infection and delayed visual recovery. The Palazzo Manzoni team walks you through the specific risk profile for your eyes before anything is scheduled.
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.”
Patient Stories
They were where
you are now
Glasses and contacts have been part of your life for years. Or reading has started to slip and you want a solution that doesn’t involve lens surgery. PRK laser vision correction can change both.
Real experiences from patients who took the step
I wore glasses for 18 years. I didn’t realize how much I’d been adapting until the morning after my procedure, when I opened my eyes and could see the ceiling clearly for the first time.
I came in expecting to just fix my cataract. My specialist explained the option of a multifocal lens, and now I see better than I did at 50. I haven’t touched my reading glasses since.
Two clinics told me laser wasn’t possible because of my prescription. At Palazzo Manzoni they offered ICL, and now I see perfectly. I wish I’d known about this option sooner.
Options
If PRK isn’t right, there’s still a path
PRK is a specifically indicated technique. If your eyes are suited to a faster recovery, or your prescription sits beyond PRK’s range, another route usually fits you better.
→SMILE
When the cornea supports a lenticule and you want a faster, flapless recovery for myopia and astigmatism.
→Femto-LASIK
When the cornea supports a flap and you want fast recovery across myopia, hyperopia and astigmatism.
→Presbyond
When the real issue is early presbyopia in your forties or fifties.
→ICL lens implantation
When the cornea is too thin even for a surface ablation, or the prescription is beyond the laser range.
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
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Get in touch
Call, email, WhatsApp, or book online.
02
Meet your specialist
A personal consultation to understand your situation.
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Your plan, your pace
Together you decide the best path forward.
Scientific research
Dr. Andrea Russo is first author of a 484-eye study after PRK and LASIK published in Ophthalmology and Therapy (2021) and of a study on topography/wavefront-guided PRK combined with cross-linking, published in the Journal of Cataract & Refractive Surgery (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.