There is a wide ranging choice of refractive procedures available today. Selections are stringent based on the topography, extent of refractive error and corneal thickness. If the individual has a thin cornea of < 500 microns, trans epithelial PRK or Surface Ablations is the treatment of choice. Herein the epithelium is smoothly ablated , refractive error ranging upto -6 diopters treated with the excimer laser and a bandage contact lens left in place for the underlying epithelium to regrow in 3 – 5 days. The final visual outcomes are very gratifying. Creating a flap is not the solution for these thin corneas. If the refractive error range is higher, ICL is the treatment of choice.