The KRC – Since 1995
The Commission on Refractive Surgery (KRC) is a joint commission of the German Ophthalmological Society and the Professional Association of Ophthalmologists in Germany. It evaluates refractive surgical procedures based on the current state of scientific knowledge. The values listed here are current as of May 2024.
For each procedure, the KRC distinguishes between two zones—and the difference between them is the difference between a routine treatment and a procedure with increased risk.
The range within which the procedure is considered appropriate and side effects are rare. The usual requirements for informed consent apply.
The range within which the procedure can still be used—but with progressively poorer results and more frequent side effects. Increased obligation to provide informed consent.
Use is not recommended. If surgery is performed nonetheless, this must be explicitly noted.
Where We Operate—and Where We Don’t
Both procedures we offer have their own limits. The colored bands indicate the KRC zones.
Trans-PRK
For hyperopia, the KRC has no recommended range of application for surface treatment—it falls within the borderline range from the outset (up to +3 dpt). Therefore, we do not treat hyperopia with Trans-PRK.
Femto-LASIK
Myopia and astigmatism are added together
A detail that is often overlooked: If astigmatism is present in addition to myopia, the KRC states that the sum of both values is decisive—not the spherical equivalent. This shifts the limit significantly downward.
Example Trans-PRK, application range up to −6 diopters
Not every LASIK procedure is Femto-LASIK
In LASIK, a thin corneal flap is lifted before the excimer laser works beneath it. There are two techniques for lifting the flap, and both may be called LASIK:
Femto-LASIK
The flap is created non-contact using laser pulses. Its thickness and edge geometry can be precisely planned and are uniform across the entire surface.
Classic LASIK
The flap is cut using an oscillating blade—referred to as a “planer” in the KRC description. The thickness varies more significantly because it depends on tissue resistance.
The difference is outlined in the guideline
The KRC specifies different contraindications for the two techniques. The key factor is corneal thickness prior to the procedure—and for mechanical incisions, the guideline requires 20 μm more reserve:
Minimum corneal thickness prior to treatment
The 20 μm allowance is the safety margin that the professional association factors in to account for the lower precision of the mechanical cut. Regardless of this, the following applies to both techniques: A corneal bed of at least 250 μm must remain beneath the flap—even after any subsequent corrective surgery.
We use: SCHWIND ATOS
We create the flap exclusively with the SCHWIND ATOS, a femtosecond laser. We never use a mechanical microkeratome—neither as a rule nor as an exception, and regardless of price: Both procedures cost €950 per eye at our clinic.
ATOS and Amaris are from the same manufacturer and are designed to work together. The femtosecond laser creates the flap, while the excimer laser reshapes the cornea beneath it—a seamless workflow rather than two devices that just happen to be in the same room.
What We Deliberately Do Not Offer
The ATOS is also capable of lentil extraction. We do not use this feature—not because the machine is incapable of it, but because two processes that run daily are more reliable than ten that run occasionally. This limitation is a deliberate choice, not a limitation of the equipment.
Four Questions You Should Ask Before Any Laser Surgery
The same goes for us. A provider who can’t answer them right away isn’t the right choice.
- What’s used to create the flap —a femtosecond laser or a mechanical microkeratome? Both are called “LASIK.”
- How thick is my cornea, and how much tissue will remain beneath it after the procedure?
- Am I within the recommended range or at the upper limit of the KRC guidelines?
- Who is performing the surgery —and how many of these procedures does that person perform each year?
We turn down cases that others accept
There are two ways to achieve a lower price: through the structure or through the indication. Those who take a broader view of the indication operate on more people—including those for whom poorer outcomes are to be expected. We take the other approach.
✓ We treat:
- Myopia up to -6 diopters with Trans-PRK, up to -8 diopters with Femto-LASIK;
- Astigmatism up to 5 diopters;
- Hyperopia up to +3 diopters – exclusively with Femto-LASIK;
- Stable values for at least twelve months
. ✕ We do not treat:
- Values at the borderline of KRC – even if technically feasible;
- Flap creation with a mechanical microkeratome
- ; Hyperopia with Trans-PRK;
- Cornea too thin for the respective procedure
- ; Cases requiring a lens solution instead of laser correction.
If the preliminary examination reveals that you are outside the scope of treatment, we will inform you and suggest an alternative procedure. In this case, we will not charge for the procedure.
What We Are Referring To
KRC Recommendations
Evaluation and Quality Assurance of Refractive Surgery Procedures by the DOG and the BVA. As of May 2024.
ESCRS
European Society of Cataract & Refractive Surgeons—the European professional society for refractive surgery and its clinical standards.
Our Equipment
SCHWIND ATOS for the flap, SCHWIND Amaris 1050 RS for ablation—a coordinated platform from a single manufacturer.
The KRC is a commission of the German Ophthalmological Society and the Professional Association of German Ophthalmologists. Its recommendations are not legally binding in Austria—we voluntarily follow them because they represent the most accurate publicly verifiable standard for refractive surgery currently available. The thresholds mentioned do not replace an individual examination.
Do you qualify?
Five questions about your age, prescription, and medical history. You’ll find out right away if laser eye surgery is an option for you—and which procedure is right for you.