Refractive surgical procedures with complications discussed in this chapter are divided into corneal laser refractive surgeries, implantation of phakic intraocular lens (IOL), and premium IOL implantation after clear crystalline lens removal. Laser corneal refractive surgery is a more or less effective procedure within its range of correction but with a main issue which is refractive imprecision and has many rare but annoying complications such as flap complications (Bowman strip and buttonhole in LASIK flaps, incomplete flap, early flap displacement after LASIK), infectious keratitis, interface complications (Diffuse lamellar keratitis, epithelial ingrowth, etc.), keratectasia, high order aberrations, tear dysfunction and dysesthesia, ocular surface syndrome, retinal complications and corneal haze after PRK. Common complications associated with phakic IOLs include pupil ovalization (with angle-supported phakic IOLs), endothelial cell loss, endophthalmitis, glaucoma, cataract, uveitis, IOL dislocation, and retinal complications. Premium IOL issues include higher expectations for spectacle independence, dysphotopsias, and decreased contrast sensitivity.