As in any other kerato-refractive laser procedure, residual refractive errors might be expected after KLEx as well. Since a second lenticule extraction is not recommended so far, other treatment options are inevitable. Due to the ease of the procedure, PRK is worldwide a very popular option but is commonly reserved for myopic and astigmatic corrections. Further, the delayed achievement of final visual acuity due to epithelial wound healing, discomfort, and risk for the formation of haze must be considered. Thin-flap laser in situ keratomileusis (LASIK) is another option that has all the advantages of virgin LASIK-like painlessness and quick visual recovery but needs precise measurements and accurate planning to avoid interaction with the original KLEx interface. The option of converting the original cap into a flap has become more popular over the last few years. To date, this option is only given with the ZEISS Visumax platform and is called CIRCLE. However, CIRCLE and thin-flap LASIK sacrifice the initial idea of KLEx as a flap-free approach, causing a stronger biomechanical impact.