purpose: to assess the impact of refractive surgery on quality of life using the national eye institute refractive error quality of life instrument (nei-rql) and to evaluate the responsiveness of our portuguese version of the nei-rql instrument to surgical correction of refractive error. methods: in this prospective study, the nei-rql, a 42-item questionnaire with 13 scales, was self-administered by 96 patients of the federal university of s？o paulo - unifesp, between march 2002 and april 2003, before and after undergoing surgical correction of refractive error. an overall scale score was determined by calculating the mean of the 13 scale scores. differences between preoperative and postoperative nei-rql scores were examined. responsiveness was assessed by calculating the size of effect for each scale of the instrument. results: refractive surgery was associated with statistically significant improvements in scores for all the scales of the nei-rql. the nei-rql has shown to be responsive to surgical correction of refractive error, and the calculated effect sizes ranged from 0.4 ("glare") to 4.19 ("expectations"). conclusions: the nei-rql is highly responsive to changes in vision-related quality of life resulting from keratorefractive surgery. we observed improvements in all the scales of the nei-rql, after surgery.