In 1985,I published in the Archives the first of a series of articles describing keratospeak—a classification and terminology of refractive corneal surgery.1 Two more recent articles on the terminology of corneal topography and laser corneal surgery have been published.2,3 Since then, refractive surgery has changed in three major ways. First, the number of techniques of refractive corneal surgery has increased markedly. Second, different procedures now ride the wave of popularity; epikeratoplasty has fallen off and excimer laser is riding high. Third, cataract surgery with intraocular lens (IOL) implantation has increasingly emphasized the reduction of postoperative spherical and astigmatic refractive errors, particularly with the introduction of multifocal IOLs and intraoperative transverse keratotomy. Intraocular lens implantation in phakic eyes is again under evaluation for the treatment of myopia (Table). Even the definition of a successful result is changing. Many consider a refractive result of ±1.00 diopter a useful yardstick,