This FAQ will provide you with answers to the most commonly asked questions by our patients.
This question is very common among candidates for laser eye surgery. The sensation of dazzling is related to what is wrongly called "dry eye". It is a fairly common complaint following laser surgery, and there are sometimes patients on forums and blogs who regret having surgery just because of this postoperative outcome.
Healthy eyes have well-hydrated and well-lubricated corneas. There is no discomfort when the eyelid passes over the cornea, no feeling of dryness, or need to blink more often than usual.
This comfort is possible due to:
Both types of glands must function optimally to ensure the good health of the cornea, however, all corneal surgeries temporarily decrease lacrimal secretion as they cut the corneal nerves that play a role in the corneo-lacrimal reflex. The lacrimal gland therefore produces less water.
This phenomenon is not permanent as the nerves will grow back.
The Smile technique is the least invasive and therefore the least disruptive to the lacrimal function (on average 3 months compared to 6 to 12 months for Lasik).
It is therefore very important to carry out a dry eye assessment before the operation to evaluate the function of the lacrimal gland and the Meibomian glands. If the lacrimal gland and Meibomian glands are normal, there will be very little risk of postoperative discomfort.
On the other hand, if there is an impairment of one of the two types of glands (rare for the lacrimal gland but frequent for the Meibomian glands) or both, it will be necessary to first treat these glands to restore normal function and thus improve postoperative results of the surgery.
In some cases, when the Meibomian glands are very atrophic, the laser is contraindicated and it will be preferable to offer ICL Staar implant types that do not affect the quality and quantity of tears. There will therefore be no risk of dryness or postoperative dazzling.
Note that many patients interested in laser surgery are contact lens wearers that they no longer support. They very frequently have tear disorders but do not realize it under the lenses which have a dressing effect that hides the symptoms. After surgery, without the dressing lenses, they rediscover their real tear status and the discomfort that results from it.
To conclude, yes, some people may be more sensitive to light after laser eye surgery, but it depends on the function of the lacrimal and Meibomian glands and the technique used. A dry eye assessment is therefore crucial before the operation to avoid or reduce postoperative discomfort.
Wearing makeup too soon after eye surgery is not recommended. Makeup contains bacteria that could cause infections. Additionally, the friction from removing the makeup could harm the healing process. For these reasons, it is reasonable to wait one week before wearing makeup after surgery with the Smile method (even though the average healing time for micro-incisions is 4 hours) and 15 days after other surgeries.
One must distinguish operations for myopia, hyperopia, and presbyopia.
For myopia surgery, there is no real minimum age, as long as growth has finished and the person is an adult. This is usually from 18 to 21 years old. It is usually recommended to wait until myopia has been stable for one or two years.
The development of myopia is not due to age but rather visual behavior. The time spent in close vision causes myopia to develop. If one quickly adapts to regularly looking far away (every 20 minutes, 20 feet away, for 20 seconds), myopia will not develop much.
For hyperopia, there is no recommended age either. One must wait until 18 years old. One knows that hyperopia will change a little as presbyopia appears. A retreatment may be necessary at that age. Contrary to a widely held belief, all surgeries can be redone: just because one has already been operated on does not mean they cannot be operated on again later.
For presbyopia, one can be operated on as soon as the first signs appear (around 45 years old). Unlike myopia, which can develop unpredictably in individuals, presbyopia will reach the same degree for everyone. So, as soon as the first difficulties appear, one knows what the total presbyopia will be and can anticipate it as the eye loses its power of accommodation. The treatment in place will take over to continue to see up close.
You can certainly have surgery on both eyes at the same time, it's actually the usual procedure when having surgery with the Smile or Lasik methods. On the other hand, when the PRK method is used, it is advised to operate on one eye and then the other a little later. Indeed, with this method, there is a frequent complication called "haze" that appears between one and three months after surgery and can impair vision for several months. It is therefore recommended that patients who have chosen this procedure ensure the good result of the intervention on the first eye before having surgery on the second eye.
There are three laser treatment methods: PKR, Lasik, and Smile. With PKR, the surface epithelium is mechanically or laser-abraded (trans PKR), and the stroma is reshaped. With Lasik, a corneal flap is cut and then lifted so that the Excimer laser can reshape the stroma, and the flap is then repositioned. With Smile, the laser passes through the anterior cornea without altering it and prepares a thin lenticule of stroma that will later be removed by the surgeon through a micro-incision. Smile is the least invasive method. It is the only method that respects the integrity of the anterior third of the cornea, which contains the most corneal nerve and is the most resilient. It is also the method that causes the least side effects.
Generally, for this short-duration operation (10 to 20 minutes), you are awake. A local anesthesia is performed using a few drops of eye drops instilled directly on the eye. This method is very effective and ensures a surgical gesture without any pain. Laser operations require the cooperation of the patient since they will be asked to fixate a light during the procedure, so they must be awake. For surgeries involving the placement of implants, local anesthesia with an awake patient is also used. However, in very rare cases (3%), general anesthesia may be used when the patient feels too stressed.
There is no age to benefit from a laser operation! However, from the age of 55, the interest of an implant operation will be discussed if the lens has lost some of its transparency. It is also possible to be operated on with the laser if one wears glasses after a cataract operation and wants to get rid of them.
Refractive surgery is the set of laser or implant operations that eliminate dependence on glasses and contact lenses by correcting optical defects. The shape of the cornea can be modified:
An intraocular lens can also be implanted:
Laser eye surgeries cost from 500 to 3,000 euros per eye, depending on whether they are performed by a chain or an independent surgeon. This price can vary greatly from one surgeon to another, from one center to another. Before deciding, it is important to thoroughly research, as price should not be the only criterion for choosing. Although laser eye surgeries are common today, they are still sometimes delicate surgeries that require a precise diagnosis, a very experienced surgeon, and meticulous follow-up. The price varies depending on many factors:
Before considering surgery, you will need to attend a preoperative consultation. This important consultation will verify that there are no contraindications to the surgery. It will be an opportunity to do a complete check-up of your eyes to be sure that they are in good health and do not present any pathologies that could influence the success of the future procedure. During this consultation, a very fine evaluation of your vision and measurements of your eyes will allow us to then propose the surgical technique that is best suited to your needs. On the day of the operation, you should plan to stay at the clinic for about an hour.
The surgery itself will take about 10 to 20 minutes for both eyes. Once in the operating room, the patient who will have received a relaxing medication is lying down on a bed. Local anesthesia is performed with eye drops. There is no pain during the procedure. The eyes are held open or spread apart, but the local anesthesia allows for no sensation of discomfort, dryness, or the desire to blink. The surgeon will need the cooperation of the patient, who will need to fixate on a light. Don't worry if the patient's eye moves, as there is a "tracker" system that allows the laser to follow the small movements of the eye and stop if these movements become too significant, then resume where it left off.
After the surgery, transparent plastic cups will be placed over the eyes to prevent the patient from accidentally touching or rubbing them. The patient should be accompanied for the return home as the vision will still be blurred for a few hours. In general, patients take advantage of this time to rest and keep their eyes closed. It is very important, in the aftermath of the operation, to follow the instructions that will have been given, especially to properly administer the prescribed drops and to maintain strict hygiene (especially hand washing) during these care processes. Starting the next day, the patients will resume their activities.
However, they must be careful to protect their eyes from dust, friction, or shocks that could compromise the results of the surgery. Postoperative consultations (the first being the day after the operation) will allow us to monitor the evolution of vision.
You can have myopia surgery multiple times. Sometimes, myopia can continue to progress a few years after a first intervention, and the patient may wish to have a re-treatment. Before any new surgery, a complete and meticulous preoperative assessment must be carried out.
This assessment will allow for any potential contraindications to be searched and all necessary measures to be taken to determine the best method to use for the second intervention. You can have a second operation regardless of the technique used the first time: radial keratotomy, PRK, LASIK, or Smile. However, a second laser operation may not be the best solution, and an implant intervention may yield better results.
Yes, hyperopia can be treated with laser or implants. If PRK is not the best choice for treating it and the Smile technique is still under development for this particular visual defect, excellent results are obtained with LASIK if the treatment parameters are well chosen. The Staar ICL implants also show great effectiveness in this treatment.
Presbyopia is treated with laser or implants. It is possible to treat all presbyopias, whether they are isolated or associated with other visual defects such as myopia, hypermetropia or astigmatism. The result of the intervention is durable and patients are very satisfied with the results. Not all laser treatments are equal. The best laser treatment is currently Presbyond. It allows to reshape the cornea and to compensate for the effects of the loss of elasticity of the crystalline lens. Treatment with implants, including multifocal implants, is also very effective. Here too, care must be taken in choosing the brand and type of implant as there are different technologies and not all have the same results. The preoperative appointment, of paramount importance in a refractive surgery project, will be the opportunity to undergo a thorough examination and to discuss with the patient to offer the solution that is best suited to his case.
The presbyopia surgery costs between 3000 and 7000 euros for both eyes. As with all surgeries, the price can vary greatly depending on the method used to treat the visual defect (laser or implants) and the quality of care desired. The entire care process, from preoperative assessment to postoperative follow-up, including the surgical procedure itself, can be very different from one clinic to another.
During the surgery, regardless of the method used (laser or implants), local anesthesia techniques allow for a painless operation. After the operation, patients do not feel any pain but only sometimes some discomfort for 4 to 6 hours. Only the PRK technique leads to severe pain for 3 to 4 days (and nights).
Unfortunately, even though optical defects can be very handicapping, laser eye surgery is considered a cosmetic surgery and cannot be reimbursed by Social Security. The complementary health insurance covers around 400 euros per eye, which, compared to the actual value of the operation, is often disappointing for surgery candidates. Beware! Some insurances encourage their clients to go to "partner" centers. This practice is contrary to the free choice of the doctor that the patient is entitled to for any medical act. If the patient chooses a different center from the one offered by the insurance, the patient must benefit from the same reimbursement.