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
The difference is what’s left untouched
Older laser techniques begin by cutting a thin, hinged flap in the cornea. The flap is lifted, the refractive correction is made underneath, and the flap is set back. It heals. For most patients, that flap becomes irrelevant. But for as long as your eyes exist, it remains an interface. In rare circumstances, such as contact sports or accidental trauma, that interface can matter.
SMILE removes the flap from the equation. The entire correction is made inside the cornea, through a single arc-shaped opening at the edge. Nothing is lifted. The surface is left almost untouched.
Three things follow from that. The cornea keeps more of its natural biomechanical strength. The tear film recovers faster, because fewer superficial nerves are affected. And the return to daily life is typically described by patients as unremarkable within twenty-four hours.
01
Flapless by design
The cornea’s surface and strength stay intact.
02
Gentler on dry eye
Fewer nerves disturbed, smoother recovery.
03
One department, one pathway
Diagnostics, treatment and aftercare, led by Dr. Andrea Russo.
Your Path to Clear Vision
Your path to clear vision, step by step.
Step 01
Book your initial examination
Call, email, WhatsApp, or book online. No referral needed.
Step 02
Meet your specialist
A thorough assessment of your eyes, a clear explanation of your options, and a plan that fits your life.
Step 03
Your treatment
Day surgery at Palazzo Manzoni. Most procedures take minutes. You go home the same day.
Step 04
See the world again
The things your vision had quietly taken from you start coming back.
Is SMILE Right for Your Eyes?
Is SMILE
right for your eyes?
SMILE is not a universal laser. It is a specific answer for a specific clinical profile, and the match matters. At Palazzo Manzoni, most SMILE candidates share several of the following.
Clinical profile
- Myopia approximately -1 to -10 dioptres
- Astigmatism up to approximately -5 dioptres
- A stable prescription for at least 12 months
- Sufficient corneal thickness (typically 500 μm or more, evaluated individually)
- Age 22 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 where the theoretical risk of flap dislocation is a real consideration, including combat sports, rugby and water polo
- Professional roles with physical or environmental demand, including military, law enforcement and emergency response
- A tendency to dry eye from contact lenses, which SMILE generally does not worsen the way flap based techniques can
- A careful disposition: the kind of patient who wants the least surface disturbance consistent with a real result
Where SMILE isn’t the right answer?
SMILE does not correct hyperopia or presbyopia, and it does not treat very high myopic prescriptions beyond approximately -10 dioptres. If any of these describes your eyes, a different laser or lens based technique is usually better suited. Your assessment at Palazzo Manzoni will identify which one.
If SMILE 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
SMILE is a proprietary Zeiss procedure, introduced more than a decade ago on the Zeiss VisuMax femtosecond laser. Similar lenticule extraction techniques now exist on other platforms, but Zeiss’s version remains the original, with the largest clinical evidence base in the field: several million procedures and over a decade 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 24 hours, the first week, and the months that follow
The evening after surgery
Blurred or fluctuating vision is normal, as is a light gritty sensation, as if something is mildly irritating your eye. Both fade within a few hours. You use the drops provided, avoid screens and sleep early.
The next morning
Most SMILE patients wake up and simply see. There is still a light haze that refines over the following days, but vision is clear enough to drive, work and move through a normal day. Light to moderate exercise is generally back on the table.
The first week
Vision sharpens progressively. Dry-eye sensation, when present at all, is typically milder and shorter-lived than after flap-based techniques. You attend your first follow-up at Palazzo Manzoni. Swimming, sauna and heavy contact sport are paused for a short defined period.
First month
Visual stability is reached for most patients. Night vision continues to refine. You attend a second follow-up.
3 to 6 months
The long-term refractive result is locked in. A final follow-up closes the surgical phase of your care. Palazzo Manzoni remains open to you for any future check-up.
Honest Trade-offs
What SMILE
doesn’t do
Every laser has its trade-offs, and honesty about them matters more than marketing.
In the first 24 hours, SMILE’s visual recovery is sometimes reported as slightly softer than Femto-LASIK’s overnight sharpness. Most patients catch up within a few days and long-term outcomes converge, but for a small number of patients, for example those who need to drive with precision the morning after, Femto-LASIK remains a reasonable alternative.
SMILE, 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 that can usually be corrected with an enhancement. Rarer but real risks include infection, interface debris 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. 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 SMILE isn’t right, there’s still a path
SMILE fits many eyes, but not every eye. If your prescription, your corneal thickness or your clinical picture points elsewhere, it usually means another technique fits you better.
→Femto-LASIK
When hyperopia or higher astigmatism is part of the picture, which SMILE does not treat, and the cornea supports a flap.
→PRK
When the cornea is too thin for a lenticule, or the surface itself needs treatment.
→ Presbyond
When the real issue is early presbyopia in your forties or fifties, not distance vision alone.
→ICL lens implantation
When the prescription is too high for laser, or the cornea too thin for any corneal technique.
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.
02
Meet your specialist
A personal consultation to understand your situation.
03
Your plan, your pace
Together you decide the best path forward.
Scientific research
Dr. Andrea Russo authored a study on corneal lenticules derived from the SMILE technique, published in Scientific Reports, Nature group (2026). 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.