Frequently asked questions
What is refractive surgery?
Refractive surgery includes all of the surgical techniques for correcting refractive errors of the eye. (myopia, hyperopia, astigmatism, presbyopia). It cannot be done by a qualified ophthalmologist surgeon. The techniques of correction based on the principle of the corneal remodeling by the excimer laser (LASIK, PKR, LASEK, Epi-LASIK, etc.) are the most practiced. In certain indications, other corrections techniques can be proposed (placement of refractive implants)...
What does the word LASIK?
LASIK: is an acronym for Laser in Situ Keratomileusis (keratomileusis by laser in-situ). Kerato, mileusis and in situ are words of Greek origin which mean respectively "cornea", "train", "in". This technique refers to the use of the excimer laser to reshape the cornea in depth to compensate for an optical defect.
What is LASIK?
LASIK is a corneal surgical procedure that allows the correction of a wide range of myopia, hypermetropies and astigmatismes. The technique of LASIK has three main time: cutting then uprising of a superficial flap, the issuance of the laser under the flap and finally the rest of the component on the redesigned corneal tissue. It is done under local anesthesia with eye drops.
What is that the PKR?
The PKR or procedures to refractive target is based on a principle similar to LASIK, 2 processes using an excimer laser to reshape the cornea. During PRK, epithelium is gently peeled after administration of drops anesthetics to numb the cornea. PRK is characterized by a long, painful healing than LASIK, because we expect that the epithelium grows back on the surface of the reshaped cornea, which takes a few days. If the procedure is painless, a feeling of discomfort, burning occurs in the hours that follow and generally lasts less than 24 hours. Most surgeons cover the surface of the eye with a special contact lens at the end of the intervention which allows, in addition to the painkillers, make the post operative pain quite bearable. The optical results of the PKR are equivalent to those of LASIK for low and medium myopia and myopic astigmatism.
What is than LASEK?
LASEK is a technique derived from the PKR, which divides the main time; Unlike that previously peeled epithelium is repositioned on the surface of the cornea after issuance of the laser beam. This variant was proposed to reduce the pain and transient inflammation observed after contact techniques. It is recommended in case of high myopia, when the thickness of the cornea does not allow the realization of a LASIK.
What is epi LASIK?
The Epilasik is a technique or epithelial coat has been automated with an epi keratoma. It is similar to LASEK that it aims to increase the reproducibility, the epithelial coat is more manual but automated.
What is that "all laser" LASIK (LASIK 100% laser, "all laser" LASIK, etc.)?
LASIK consists of the initial cutting of a flap (or component) superficial which allows access to the thickness of the cornea where the corrective excimer laser photoablation is then issued. When the initial cutting of the cover is performed by a femtosecond laser (and not a mechanical microkeratome), we can speak of "LASIK all laser".
Since when is LASIK surgery?
LASIK is a very distributed internationally for a decade. The first intervention was in the early 1990s and many clinical trials then were made in Europe and the USA. It is important for our main constituent the technique of LASIK times have a certain decline since surgery by corneal reshaping is then more than a half a century. It is the use of laser excimer that is newer and permit thanks to its precision and the absence of thermal side effects to refine the corneal reshaping with refractive aiming technique which there are today two main variants: LASIK (laser is delivered in depth after cutting a thin corneal Strip) and the PKR (to sight Refractive procedures) the laser is issued on the surface). The PKR was developed during the late 1980s and has quickly supplanted by its precision and its security the ancient technique of radiaire keratotomii, which consisted in the realization of corneal incisions in bicycle spokes distributed around the edge of the cornea. More recently, the PKR has evolved to give birth to variants such as LASEK and EpiLASIK the.
Who can benefit from the excimer laser surgery?
Short-sighted, farsighted and astigmatic can benefit from LASIK or the PKR. To do this, they must be motivated by the desire to escape completely or strongly reduce their dependence on glasses and accept the risks of the surgery. Short-sighted presbyopic may benefit from LASIK and be rid of the port of corrective lenses for vision from afar, if you accept the idea of wearing glasses for reading. It is also possible to propose to the presbyopic myopic monovision (or rocks) technique that emphasizes the near vision on an eye through a slight under correction.
The presbyopic hypermetropes are good candidates for Laser refractive surgery because in addition to an improvement in vision from afar, they benefit from a partial recovery of the vision closely and can often again read a map of the menu, see the hands of their watch without correction.
What are the contraindication to surgery through LASIK or PKR?
The physician must assess many factors to determine the eligibility of a patient to LASIK or laser surface techniques. Then the myopia or hyperopia must be stable (the correction in glasses or lenses no longer changes for more than a year). Candidates for refractive surgery must legally be adults (> 18 years).
Nearsightedness should be less than 10D, hyperopia less than 6D, and astigmatism lower than 4D to expect a good result with excimer laser surgery.
Various ocular or general conditions are a contraindication to the process and the case If necessary, the surgeons of the Center will not perform this one. Other conditions can complicate the intervention and thus increase the risk of complications. Patients who suffer from one of these conditions must discuss their eligibility and expectations with their physician.
Some patients have a profile compatible with the different techniques, while others are more able to benefit from LASIK, or in the inverse of a surface surgery (PKR, LASEK, ect...). The degree of correction to be performed, the corneal topographical characteristics, the thickness of the cornea are all key elements in the choice of the technique most suitable for a given patient.
LASIK has the advantage of rapid Visual recovery and superior operating comfort than surface techniques. To be feasible, the cornea must be sufficiently thick and have regular geometry (no significant asymmetric deformation). In fact, it should not be carried out in case the pre-existing corneal fragility because the cutting flap could aggravate this fragility and lead to an unstable post-operative vision. When LASIK is not indicated for these reasons (cornea of less than normal thickness, slight asymmetric corneal deformation measured at corneal topography), it is generally possible to propose a surface technique (no cutting of a corneal shutter). All studies published in the scientific literature show that LASIK and surface techniques provide equivalent results for the support of Visual defects of moderate and medium importance (up to 6D of myopia, 4D hyperopia, 3D astigmatism). In case of corneal pathology known as keratitis, Keratoconus, the realization of refractive surgery with laser is contraindicated. It is partly for this reason that it is important to carry out a corneal topography and a measure of the thickness of the corneal (pachymetry) to confirm the eligibility of a patient and to make the choice of the most suitable technique.
In case of a pronounced pre-dry eye (frequent or permanent treatment by artificial tears), it is often preferable to opt for a surface technique, as LASIK can accentuate the dryness of the eye in a post-operative manner.
Should a satisfied its contact lens patient continue to wear them or undergo refractive surgery?
The majority of surgeons believe that patients who are not pestered by contact lenses should carefully evaluate the pros and cons of LASIK or the PKR. Some professions or sports or leisure activities require a minimum of tenths of Visual acuity without correction and can ask the indication for refractive surgery.
Should what results we hope surgery laser (LASIK, PKR)?
LASIK and the PKR aim to improve the uncorrected vision, IE the vision without corrective lenses of most patients undergoing the procedure. More than 90% of patients who have a moderate or low myopia reach a 8/10 vision, vision considered sufficient to drive without glasses or contact lenses. Many patients can expect a vision 10/10 or higher.
However, it is not guaranteed that a perfect vision will be achieved. In addition, in the case or pronounced hyperopia (greater than-8D, respectively). and + 4D), expectations must be more moderate. The people most satisfied with the results of an excimer laser correction have understood and measured the potential risks and possible complications of surgery and have realistic expectations regarding their post-operative vision.
Are the results permanent and final after surgery by LASIK or PKR?
The effects of refractive surgery are permanent and do not dissipate with time. However, it is important to remember that some eye characteristics a person can always change over time. Also, many surgeons recommend conduct intervention after the eye has acquired a stable form. Thus, the surgery is not recommended for children because their eyes are changing much with the growth and their vision would then again be adjusted a few years later. If the procedure is performed after the age of 18, the chances of long-term stable correction are greater. However, even the eyes of a patient over 18 years can still change. Accordingly, the surgeon will evaluate the changes that have occurred to decide whether to wait for their downturn. The patient must also note if the results are generally stable, they can be changed by complementary processes took place later, as needed. SCAR phenomena are exacerbated in some patients and may be at the origin of a "regression" in the effect of the surgery in the weeks following surgery. Finally, it was noted that the risk of progression of myopia is proportional to its importance (high myopia progresses faster than low myopia).
How long the process of nearsightedness surgery lasts t - it?
The surgical procedure (LASIK or PKR) takes about 10 min. for 2 eyes, including the preparation time laser (creating LASIK corneal cover by laser femtosecond, epithelial surface technology coat) and the application of the excimer laser. The time of issuance of the laser is usually less than 1 min. The technique is done under local anesthesia by drops that the duration of action far exceeds that of the surgery.
Can I drive immediately after LASIK?
The patient may feel uncomfortable or have blurred vision for a few hours after the procedure. On the other hand, if a sedative is administered before surgery, it is recommended the patient to not drive after surgery or at least 24 hours. A certificate mentioning the non obligation of port of lens correction for driving is issued upon request to the patient after the operation.
What type of anesthesia is used for LASIK and the PKR?
The process is carried out using a topical anesthetic (eye drops), which removes the transmission of pain impulses. A light oral sedative may be given to the patient to help him relax before surgery.
Is the intervention painful?
A topical anesthetic (eye drops) is administered to numb the eye to remove the pain during the procedure. In LASIK, when the surgeon applies the suction ring, the patient feels a slight pressure just until his vision clears for a few seconds. The microkeratome (instrument used during the lambeau) and the laser do not cause pain or discomfort.
For several hours after LASIK's intervention, some patients describe a slight sensation of foreign body, such as the uncomfortable wearing of lentils. This sensation usually dissipates within a few hours.
After surface surgery, discomfort or even more or less severe pain usually occurs one hour after surgery. They can be calmed by taking painkillers in tablets. The vision remains slightly blurred for about 72 hours. If a lens has been placed on the eye by the surgeon, it usually withdraws it 5 days after the surgery.
Can we perform LASIK and the PKR on 2 eyes the same day?
A simultaneous bilateral LASIK is possible (2 eyes are made subsequently in the same meeting operatoirie). In the majority of cases, bilateral LASIK gives good results and is even safe and effective. More than 95% of the people opt for simultaneous bilateral LASIK.
Complications of laser in situ Keratomileusis for the correction of myopia, ophthalmology, 1999; 106 (1). (Results from Emory's trial which considers that 1 062 eyes did not notice any statistically significant differences with the bilateral process.)
The PKR can also be performed consectitely on both eyes in the same session, in order to promote a rapid Visual rehabilitation, and avoid the discomfort caused by the difference in correction between the two eyes between surgeries.
How long the cessation of professional activities is necessary after surgery?
It depends on the nature of the professional activity. Some tasks requiring very sharp vision (work on micro instruments, conduct.) can be difficult to perform for 1 or 2 days. Most patients can return to work the next day after LASIK, if their vision is adequate for their positions. In laser surface, wait for the disappearance of Visual discomfort, which takes between 24 and 72 hours.
Can do sports after the procedure?
Common daily activities can be resumed immediately after the intervention of LASIK, and from the removal of the bandage in surface laser lens... However, for at least 2 weeks, avoid any activity that would result in the penetration of sweating or dirty water (pool) in the eyes. Lenses for protection during the practice of a sport of contact (martial arts, wrestling, ect...) is recommended, even in the absence of prior intervention! It is important to discuss with the doctor of the resumption of the activities after the LASIK or laser surface. In principle, a trip doesn't have to be scheduled less than a fortnight after the surgery unless a control is possible at the place of destination.
How long does take before you see, and that vision is optimal after refractive surgery?
The LASIK procedure is characterized by a rapid recovery of vision. Most patients get good vision the same day of the intervention, and their eyes return almost to normal after a night's sleep in laser surface, a few days are necessary for each eye. However, the vision may continue to improve for 2 or 3 months, particularly if the correction is pronounced, and operated hypermetropia. The patient who received the hypermetropique LASIK must often wait a few weeks to see clearly by far, because near vision improves first.
How the flap attaches after the LASIK procedure?
The flap is repositioned by the surgery at the end of the intervention. The grip is immediate, but it is strengthened in a few days. It is prohibited to rub their eyes after LASIK and transparent shells are placed on the eyes for the night.
Should postpone glasses once stable results of the refractive surgery operation?
Most of the patients who benefited from refractive surgery don't wear glasses for daily activities. However, the older patient over 40 years may need to wear glasses for reading due to the natural aging of the eye known as the presbyopia. This condition appears with or without LASIK. Some patients will need an order from minimum correction for some activities such as night driving (initially strong myopia).
Eyes have look different after the refractive laser surgery?
No. The eyes have exactly the same appearance (brightness, color, ect...). Sometimes there are small traces on the white of the eye for a few days after LASIK, which eventually subside completely.
Are you there a risk of losing the view by operate in laser refractive surgery?
No. Excimer laser surgery techniques benefit today technical enhancements and security systems that limit the impact and importance of ocular complications. Laser treatment is only the superficial part of the cornea, and is made "to closed globe' (there is no opening of the eye). Complications include corneal tissue that helps focus the image at the bottom of the eye, but not the retina or optic nerve which are the structures involved in the detection of light.
Have you it the significant risk of severe complications?
Most clinical trials and studies of hundreds of cases showed that the LASIK and PKR are a minimum of complication risk when their indication is well put. However, LASIK is a procedure performed on a delicate tissue of the eye, and complications are always possible. The overall complication rate with these techniques is a fraction of 1%. Even if a complication occurs, it is rare that she sounded significantly on the vision if it is supported without delay by a competent team. Most complications can be prevented by careful selection of patients, and the strict respect of the operating procedure (asepsis, centering of the treatment, ect...)
In summary, the essential time of refractive surgery is pre-operative consultation; exclusion of bad candidates (unfortunately not everyone is operable) prevents the occurrence of possible complications.
How is the vision at night and in the dark after the procedure?
Night vision problems can be prevented in majority by the issuance of the treatment on a region larger than the pupil dilated. Just after the intervention, may that the patient, if the lighting is low or dark, perceive of low light, a Halo or a radiance around light sources live. Generally, this type of phenomenon does not led or practice activities at night, and in the vast majority of cases, is temporary and lasts only a few days or at most a few weeks. New technologies such as the OPD and personalized treatments allow a better support of these phenomena.
Are the eyes dry after the completion of LASIK?
Dry eye is a possible complication after LASIK. The presence of a dry eye prior should encourage them to enhance the moisturizing post operative treatment or in some cases do choose a treatment by surface laser (PKR). Before the surgery, the surgeon will check that the corneal surface is well healed (absence of dry keratitis) to perform the operation safely. In some cases, the laying of tear caps to reduce the need in artificial tears before and/or after the intervention.
Why the correction of myopia in a presbyopic patient interferes with near vision?
A presbyopic patient can no longer perform the update to see net objects remotely reading (reduction of accommodation). This refers to a situation where by far the vision is corrected. If it is short-sighted, the patient sees blurry far without correction, but there is a distance where the vision is clear without glasses. This is the definition of myopia: "default", the vision isn't sharp by far but more so close that myopia is pronounced. For example, if the myopia is-3D, the distance where the vision is clear without effort is 1/3 = 33 cm. In fact, a myopic-3D sees net and effortless to 33 cm, any stage of his presbyopia. If one corrects myopia, so far uncorrected vision becomes clear, but near vision requires "accommodative effort" that may not be enough at the presbyter.
Myopia occurs t it in patients over 40 years?
Yes because it is possible to obtain a good distance vision without correction in these patients. However, most of the 40 people and more will have to wear glasses to read if their eyes are corrected for distance, because they will lose their gradually their capacity of accommodation as they age. This condition, called presbyopia, can in some cases be treated surgically and encourage the surgeon to propose some options such as monovision. This option allows the patient to use one of his eyes to see distance and another closely. It can be simulated using contact lenses. Although monovision meets the needs of some, this is not the case for others, and the patient should discuss the options with your doctor. Most surgeons suggest to try monovision with contact lenses for a few days before opting for it by laser surgery. A more recent option is to implement a Kamra (Acufocus) implant in intra stromal (inlay), under the flap of LASIK. This implant is an optical diaphragm, which allows to increase the depth of field and preserve some of the near vision, while allowing to correct distance vision.
If the vision by far is corrected by myopia surgery, what will be the ability to see without glasses?
Not presbyopic patient (less than 45 years on average) who opts for LASIK or the PKR to correct his vision at a distance, must expect a clear overall vision, and without glasses from near and far. However, the patient more aged 45 can not see clearly near images especially if he had surgery for nearsightedness in both eyes and will normally have to wear glasses to work and read closely. Conversely, the presbyopic patients operated of hyperopia are addicted reduced correction closely after the intervention. This dependence can be further diminished by the realization of a monovision (one eye is corrected to see net from a distance without glasses, the other to see up close).
I haven't worn glasses until the age of about 40 years, recently I must take not only to see net, but my vision by far also drop and I now wear glasses to see clearly at all distances. Why?
The presence of a weak and well tolerated farsightedness is very common. As long as the accommodation works well, she is asked to correct distance vision "naturally" ("forcing" barely, often unconsciously, we get to see very well from a distance). The hypermetropic low and young adult has a good visual acuity without correction, the price sometimes "Visual fatigue". However, the arrival of presbyopia brings "decompensation" of this phenomenon. Not only near vision becomes very difficult, but the vision by far also deteriorates. Surgical correction of hyperopia by LASIK improves distance vision and induces a beneficial effect for near vision.
Is the intervention by LASIK or PKR covered by social security?
Although LASIK and the PKR is not cosmetic procedures, it is considered a comfort operation. Health insurance French as well as insurance programs do not financially cover LASIK or the PKR or other surface techniques. However, some private insurance companies reimburse part or all of the costs of the procedure. Check with yours.
When the laser (LASIK or PKR) surgery is not indicated, what are the other surgical techniques likely to correct vision defects?
The insertion of an implant in the eye most often to correct refractive errors that exceed the indications of LASIK and the PKR. These implants are designed to correct high myopia (beyond of - 10 d) or hypermetropies (beyond 6 d). They are placed in the room before (in front of the iris) or after (at the back of the iris) of the eye. They are designed for a maximum tolerance but require annual inspections in order to verify the absence of eyestrain and corneal edema. Their indications are limited.
After the operation of refractive surgery, when will I see an ophthalmologist?
The surgery patient must be examined the next day of the operation, and between 8 days and 3 weeks after the type of technique (LASIK/PRK). Then, it is important to continue an annual eye check with his ophthalmologist to check eye pressure, the State of the fundus, ect... The operated eyes retain their anatomical peculiarities, as well as of possible pathological predisposition. Intraocular pressure (underestimated by post-operative measures due to the change of corneal geometry) and the fundus should be regularly monitored. Always mention the fact to have been operated in refractive surgery in ophthalmology consultation. Indeed, the lens correction does not affect retinal State of (former) short-sighted, who retain a retinal fragility more important than those of subjects normalsighted or farsighted.
Corrects you we also during surgery for myopia astigmatism?
Astigmatism, when present, is responsible for a part of the blur of the image. It is therefore corrected at the same time as nearsightedness by during the intervention. Just the surgeon to enter the digits corresponding to the magnitude and the axis of astigmatism in the software that drives the excimer laser.
Have you it interest to opt for a cut of the flap by mechanical laser femtosecond rather than microkeratome in LASIK?
The use of the femtosecond laser for in LASIK stromal component offers several advantages over mechanical cutting. The main concern:
-1) the possibility to visualize the progression of the realization of the flap , and above all to be able to resume immediately case of "suction drying" which causes a dissolidarization of the retaining ring with the eye. When the release occurs during a mechanical cut, it is impossible to immediately resume cutting, and in some case , the LASIK technique is no longer possible or risked ( flap partial, decentralized, dislocated, etc.). On the other hand, the resumption and continuation of LASIK surgery is possible in most case with the femtosecond laser.
-2) the best predictibility of the cutting thickness: this is particularly important in case of strong myopia, not to overthin the cornea
-3) the possibility of optimizing the centering of the flap . The Intralase laser provides a very interesting option by allowing the surgeon to center the flap on the pupil , in order to increase the size of the ablation zone, prevent shifts and limit the irregular astigmatism observed in case cutting Center.
The use of the femtosecond laser, however, induces an additional cost, and this partly explains the disparity between some centres and some surgeons.
However, the safe and functional benefit offered by this technology leads me to perform 100% of my LASIK procedures with the femtosecond laser.
Why you you sometimes red spots on the white of the eye immediately after LASIK, and how long will they disaparaitre?
When performing LASIK, the laying of the positioning of the femtosecond laser system suction ring is at the leaf level, that is to say the area around the cornea and that is covered in the Periocular conjunctiva, which is a finely vascularized tissue. The wall of the conjunctival capillaries can be weakened by contact with retention ring and cause a hemorrhage within the conjunctival tissue micro. The complete disappearance of these bleeding usually occurs within a few days or even a few weeks after LASIK.
Is it necessary to shift the response to an infection (colds, flu) ORL? or how long does take between the judgment of the clinical signs and the intervention?
If the intervention is responsible for marked general symptoms (high fever, fatigue, aches, etc.) and that there is a concomitant violation of the ORL sphere, it is best to stagger the intervention, which will happen as soon as healing, or at less the end of the acute phase. The risk is mucosa DPOs of an infectious outbreak of neighborhood spread.
Cataract surgery is more complicated after treatment of myopia by Zyoptix
The treatment of myopia by Zyoptix is a 'custom' treatment of dealing with the optical defects of the eye in their entirety. It requires the collection by a (Zywave) of ocular wave-front aberrometer. Generally, nearsightedness and astigmatism the bulk of the correction for patients benefiting from this type of treatment is first intention. It is therefore in the general framework of the cataract surgery after corneal refractive surgery. There are no particular technical problem for the actual surgery. On the other hand, the calculation of the power of the implant to be inserted must be done appropriately, with specific formulas for the corneal power rating, and the prediction of the final position in the eye. This issue is no different after treatment conventional or custom (ex: Zyoptix).
I'm amblyopic, do I need surgery?
Amblyopia often occurs in a context of inheritance, when a refractive defect (astigmatism, hyperopia, etc.) is not detected early enough in childhood. The interest of correct this optical (originally from amblyopia) defect to adulthood her depends on the degree of amblyopia. Is it is low (at least 6 to 7/10th), then the indication can be justified.
If it is pronounced (e.g. around 1/10 not upgradeable), there is little chance that the operation will be useful. In fact, amblyopia is a problem of sensory origin: even though optically corrected, the information that the amblyopic eye "sees" correctly is misinterpreted at the level of the brain areas involved in the vision.
Can you operate hypermetropic patients at + 6 Dioptries, if the pre-operative examination is favorable to them?
The reasonable limits of the correction of hyperopia by LASIK are rather located within 4 to 5 diopters. In the past, several side effects are likely to tarnish outcome of surgery (luminous halos, permanent impression of the contrast sensitivity reduction). A significant regression of the effect printed by surgery is also the rule for the achievement of strong positive corrections (hyperopia). However, the partial reduction of hyperopia may bring some profit in 'young' people (less than 30 / 35 years in this context), IE which can well accommodate to compensate residual 1.5 to 2 D hyperopia (we don't treat that 4 D for example with LASIK), and/or be able to certain professions (air crew etc.).
For older patients, surgical Crystalline lens (similar to cataract surgery) can be justified by case intolerance to lentils, for example.
In what indications refractive implant type RESTOR can be proposed? As part of a comfort surgery where the patient wishes no longer wear correction, is the most appropriate technique? what is the seniority of the method of Diffractive multifocal implant type RESTOR?
The Restor implants are multifocal Diffractive implants (bi-focaux). They are used as "artificial crystalline" after removal of the lens in cataract surgery (when the lens is clouded) or known as the "clear lens" surgery (when the lens is not clouded: in this case, there is no cataracts but we use the same technique to remove the lens and replace it with the implant: this is the technique of "comfort" to which you make reference). These implants provide a good sharpness of far away and close (35 to 45 cm), without the need for additional correction by glasses. This technique however has a cost, first financial (multifocal implants are the responsibility of the patient), but also functional because some visual disturbances are expected (halos around bright lights, uncomfortable intermediate vision). However, if the indication is well defined, and that there is not likely to interfere with the optical result associated eye problem (corneal astigmatism uncorrected, retinal pathology, etc.), the results are generally satisfactory and the independence to the optical correction after the intervention is high.
What is an "infra-clinical" Keratoconus?
Infra clinical Keratoconus is a form early and/or stable and limited of Keratoconus. We can't detect it in the standard eye exam (refraction, slit lamp examination, background look, etc.). Indeed, at this point, the affection is too limited to give signs "macroscopic" as a visible thinning, corneal opacities, etc.
The diagnosis of an infra-clinical form of Keratoconus is carried out thanks to the corneal topography: classically, it is then detected an irregular astigmatism, and/or a cambled cornea, but these criteria are not very pronounced, and do not allow to pose with certainty the diagnosis of Keratoconus. These manifestations are visible on the anterior specular topography (topography by Placido disk), i.e. the examination which consists in analyzing the image of the reflection of concentric mires on the cornea, is then referred to as "suspicious form". This must be done to reconsider the realization of a LASIK.
This previous specular topographical examination was the first available, and was long the only topographical examination before the elevation topography (which allows to measure the posterior face of the cornea as well as the thickness at any point of the coral wall) appears.
In medicine as elsewhere, a certain "conservatism" certainly explains that the criteria derived from the elevation topography are still disputed by some authors, who consider that a previous specular topography is sufficient to detect infra-clinical forms of Keratoconus. We think on the contrary that there are some forms that we recommend to call "frustes", which are detectable thanks to the analysis of the "point-by-point" thickness of the cornea, as well as other data such as the posterior elevation, the location of the point thinner, etc., in short: criteria derived from the study of the thickness and the back face of the cornea, and which are not provided by the specular topography of Placido. In simple terms, a normal image in anterior specular topography is not enough to eliminate the diagnosis of infra-clinical Keratoconus.
In our view, this justifies the systematic realization of an elevation topography (with measure of the corneal point-to-point thickness: estimation of the spatial distribution of the corneal volume: corneal tomography) before refractive surgery, for detect the earliest forms of Keratoconus, which constitute a contraindication to LASIK (risk of post-LASIK ectasia). The elevation topography with precise measurement of the corneal thickness "point by point" is provided by the following instruments: Orbscan, Pentacam, Galilei, Tomey TMS-5.
In more statistical terms, the sensitivity of elevation topography and combined optical pachymetry is greater than that of the previous topography for the diagnosis of infra-clinical forms of Keratoconus.
What is the difference of result you it between the technique of lasik and lasek?
The difference between these two technique in the site where the correction (excimer laser) is issued. In LASIK, the laser (excimer) treatment is issued in the thickness of the corneal tissue (stroma). To do this, we realize a "hood", with a first laser called "femtosecond laser". Once the flap is raised, who sculpts the cornea (excimer laser) is processed, then the cover is rested "on top". In Lasek, it does not cover, but a coat of the epithelium, which is a thin layer on the surface of the cornea cell. The laser is then issued to the corneal surface, then the epithelium is repositioned. Today, however, it is common not to rest the epithelium (most of the studies and our experience strongly suggests that it doesn't help to reposition, and that it is better to remove it). The epithelium "regrowth" and re-smooth corneal surface (in 3 to 4 days), under a contact lens that is removed to J5 about.
Why these two techniques? LASIK has the advantage of not causing pain in the first 24 hours, but can only be carried out if the cornea is sufficiently thick and regular (no suspicious form of Keratoconus). If the cornea is thin and slightly irregular, then one prefers to perform a surface photoablation technique like the LASEK.
Finally, there is no difference in results between these two techniques for myopia less than 5 or 6 dioptria. Beyond that, there is more risk of increased scarring (and under correction) in LASEK.
What is than a fruste Keratoconus?
Fruste Keratoconus is a clinical entity vague. Some authors prefer the term "infra clinical Keratoconus". It can be defined as a corneal attack not scalable, of fortuitous discovery, which has some features but dimmed the Keratoconus. There is often an asymmetry very moderate in corneal topography, a slightly thinner cornea, etc. One thing is certain: Keratoconus uncouth or infra clinical against indicates the achievement of LASIK. Indeed, a large proportion of the rare cases of ectasia corneal LASIK post was observed in patients who had a sub clinical Keratoconus unfortunately not detected... The screening of Keratoconus infra clinical motivates the systematic realization of corneal topography in the pre operation check. We recommend the realization of a topography not only prior (Placido) but also later, as well as a detailed mapping of the thickness of the cornea (corneal tomography), available through the following instruments: Orbscan, Pentacam or Galilei.
What is the Intracor procedure?
The Intracor procedure is to create a series of concentric incisions in the corneal tissue using femtosecond laser Technolas. Its indication range is normalsighted presbyopes (good vision from a distance without glasses) or slightly farsighted (less than one diopter: lower correction to + 1 d - addition - for near vision). The exact mechanism responsible for the effect is not completely identified, but it is of biomechanical nature cuts induce relaxation of the corneal tissue responsible to a central bulge. This bulge induces an increase in corneal power that provides a diopter addition to improve near vision without too degrading distance vision. This technique is recent and not benefit not to a very large recoil. It has the advantage of not being very invasive in terms of its realization (cutting a corneal slats is done without opening of the corneal surface). The potential drawback is the lack of predictability of the effect of the incisions, irreversible character and the uncertainties related to the centering. There is indeed no obvious clinical way to identify with certainty the Center corneal aiming, IE the precise spot where the Visual axis "pierces" the corneal dome.
What is the procedure of Kamra / Acufocus?
This procedure is intended to increase the depth of field willing to correct their presbyopia over one eye (the eye the says "non dominant", often left for right-handed people), in order to not be completely dependent on glasses for close-up subjects. She is to insert into the cornea implant (Kamra) that is intended to reduce the pupillary opening at 1.6 mm and thereby increase the depth of field. As a result, it is one of the few procedures of refractive surgery for presbyopia correction mechanism is well known. Vary the aperture to modulate the depth is a well known process of photographers. The kamra resembles a pierced confetti: its external diameter is a little less than 4 mm and thickness equal to 5 thousandths of a millimeter. It is pierced by a central hole of 1.6 mm. It must be positioned under a flap in the femtosecond laser. At the Emmetropic presbyope or very slightly nearsighted (less than 0.75 diopter), the implant can be inserted without associated with laser treatment. In other cases (myopia or hyperopia), the kamra may be placed after a laser treatment to correct distance vision. This technique is relatively recent, the recoil is 4 years for the first patients operated. It has the advantage to be accurate in the mechanism used, and can be used as part of a correction of vision from far and near, in association with classic photoablation (LASIK) technique where the creation of a corneal flap is necessary anyway. The tolerance of the implant is an item to check in time, it seems satisfactory provided that its insertion is done in the deeper corneal stroma. Another advantage not negligible, it is a reversible technique, because the implant can be removed in case of intolerance.
Could the laser procedure lighten the color of my eyes that are clear Brown?
Corneal refractive surgery does not cause absolutely no change in the color of the eyes (which is that of the iris, and not of the cornea).
Is it possible to have surgery from Lasik following an operation by PKR who would not have given the expected results?
This type of reoperation is according to me not without risk. When a PKR has been achieved, the superficial stromal layer called layer of Bowman (part of the stroma located just under the corneal epithelium) is "vaporized". This acellular layer is important because it explains much that LASIK is not "haze" complicated. The haze is an inflammatory stromal reaction due to an excessive laser corneal tissue ablation, in which cells of the corneal epithelium and the stromal keratocytes interactions play an important role. After PKR, this acellular layer of Bowman disappears and if a LASIK is performed, the inflammatory stromal reaction risk is increased. In addition, the geometry of the cornea no longer standard (flat cornea at the centre), cutting risks are higher (especially when cutting with a mechanical microkeratome, this is less certain with the femtosecond laser). After PKR, a recovery in PKR is better months, when this one is feasible.
Why we choose the low- and short-sighted in most optical studies? (strong short-sighted are usually excluded from these studies)
There are specific studies for the optical result of strong myopia: Brahma A and al. Safety and predictability of laser in-situ keratomileusis enhancement by reelevation flap in high myopia. J Cataract Refract Surg, 2001; 27: 593-603.
Alio JL et al. Ten year follow-up of laser in situ keratomileusisfor high myopia. Am J Ophthalmol, 2008; 145:55-64.
An article on LASIK for correction of high myopia is a download on this site: https://www.gatinel.com/wp-content/uploads/2010/10/LASIK-myopie-forte-gatinel3.pdf
Is it mandatory not to wear lenses 48 h before the appointment for the pre-operative balance sheet?
It is always better not to wear soft at least 48 hours prior to the pre-surgery contact lenses. Indeed, wear lenses, when it is prolonged, can cause changes in the eye's surface and change the exams. In the case of port extended of rigid lenses (hard lenses), the port should ideally be stopped at least one month before the pre-surgery. Indeed, the hard lenses-induced changes are more sustainable. They are generally interested in the epithelium of the cornea. It may take several weeks before finding a natural architecture.
Often people over 90 years after wearing glasses for presbyopia between 50 and 90ans, come again to read the newspaper without lunttes... without any intervention... is you there a term for this?
Two factors contribute to this paradoxical situation:
-the onset of an evolutionary cataract, in particular of nuclear form, often induces a so-called "index" myopia (the refractive index of Crystalline lens increases). But myopia allows a clear vision... closely.
-reduction of the pupillary diameter with age (senile myosis). Reducing the pupillary diameter causes an increase in the depth of field that also promotes close vision.
During how long does time after setting up a multifocal implant, do the halos last?
The presence of bright halos around bright lights is very common in after multifocal implant. There are related to the nature of multifocal implants (halo seen in vision by far is the intended home of nearly light energy but who is de-focused). With time, a sensory adaptation occurs and results in a reduction of the perception of these halos, but they are principles to persist even after several months since they are still once tied to the concept of multifocal implant. For this reason we reserve multifocal implant for patients wishing fervently no longer wear glasses from far and close after cataract intervention, and who accepts the cost functional.
What's the point of a lasik if you can immediately do a surgery with a multifocal implant placement?
LASIK is a technique that is exerted on a superficial eye tunic (the cornea). This is a minimally invasive technique, and explains the success of this technique (with the quality of the results provided). LASIK (and more generally the type excimer laser techniques including the PKR, LASEK, etc.) are a priority in young or less young subjects, when the expected result is satisfactory and there is no of contraindications to these techniques. The realization of a LASIK surgery makes more difficult technically cataract intervention.
Multifocal implant surgery requires the exeresis of the Crystalline lens and its replacement with a multifocal implant. It is therefore reserved for patients who have a cataract or are approaching the age in which this procedure is practiced (about sixty and more, approximately). Also, the existence of a strong amétropia (e.g. strong myopia >-10D, strong hyperopia > + 6D) can justify surgery with mono or multifocal implant in younger patients (quarantine). It is however a more invasive technique, both eyes are not operated on the same day, and an anesthesia consultation (for an anesthesia that will be local) is necessary in the preamble to the intervention. Some operators, who practice cataract surgery but not refractive laser surgery tend to favor these techniques for correcting visual defects: medical ethics however recommends to achieve the least invasive technique when several alternatives are likely to provide an effective optical correction.
My son had surgery to LASIK with laser femtosecond 10 days ago. His eyes are always red, is this normal?
The appearance of "red spots" on the white of the eye is common after LASIK. They correspond to the occurrence of small localised conjunctival hemorrhages. They disappear completely within a few weeks.
Is it possible to correct the astigmatism with the laser?
Contrary to widespread opinion, the correction of astigmatism is routine in corneal surgery (LASIK, PKR). Astigmatism is related to the excessive toricite of the cornea (excess of difference in curvature between the different corneal meridians). The goal of treatment is to sculpt a corneal profile to reduce this toricite. This treatment is combined with myopia or hyperopia, either LASIK or PKR. It is possible to correct the astigmatism which magnitude can reach up to 6 dioptires.
Surgery laser surgery by a child of less than 5 years of glasses for high myopia - 8 d can be profitable and stop the evolution of disability
Refractive surgery is practiced than in adults, and the paediatric indications are extremely rare. The optical correction of children must be performed in glasses, then lenses, it is important to check this in order to slow the progression of myopia. Surgery would not reverse this trend, and would in any case very difficult to achieve on a child of 5 years.
In the case of eccentric fixation, with Visual acuity of 10/10th in correction glasses, any surgical technique is contraindicated or one of them is possible?
Everything depends on what mean you by "eccentric fixation". The realization of a refractive surgery requires a good centering. This can be accomplished in adjustable way, in order to marry the patient pricing strategy. The presence of a wide angle Kappa can be taken into account when issuing a correction laser slightly de-centralized ablation Center in the direction of the deviation angle kappa-induced.
Can cataract surgery occur after the myopia surgery?
Yes, myopia surgery poses no technical problem to a later cataract surgery. However, it required specific formulas for the calculation of the implant (biometrics).
Can I use these various laser operations while my cornea is fine according to my eye doctor?
It is difficult to answer your question without knowing precisely the thickness of your cornea, as well as your correction, your age, the existence of (s) risk factor for Keratoconus (disease of the cornea that is characterized by a reduced thickness) and irregularity of curvature which increase over time. Moreover, the thickness is not everything, there must also be the cornea regular (absence of beginner Keratoconus). Only a regular topography can reveal precisely the regularity of the curvature of your cornea. Thus, the realization of a LASIK with end cover (femtosecond laser cutting) is nevertheless prohibited if a thin cornea is also irregular on the map. However, in some cases, when the cornea is fine, but sufficiently regular, a technique of laser surface is possible (low to medium myopia). When any corneal surgery is indicated, the possibility of a technique by implantation (implant phakic or pseudophake) can be discussed.
Can you fix a farsightedness appeared after a surgery of radiaire keratotomii?
Radiaire keratotomii was a technique to correct nearsightedness by performing radiaires incisions in the cornea. Today it is abandoned in favour of photoablations excimer laser techniques (LASIK, PKR,...). Radiaire keratotomii exposed to the risk of secondary hypermetropisation. Many patients, operated in the years 80/90 of myopia, today are "corrected" (hypermetropia) and have crossed the age when presbyopia sets in. The combination of these two visual defects results in a permanent annoyance, especially near vision. To surgically correct this "secondary" farsightedness, we can propose a technique of laser surface (PKR). The results are more vague on a Virgin cornea of any surgery, but more often lead to an improvement of the uncorrected vision, both far and near. In some cases, a personalized treatment guided by the OPD and/or corneal topography is indicated. LASIK is potentially able to allow the issue of the hypermetropique photoablation; However, cutting a flap exposes some complications (epithelial invasion). The PKR allows to get rid of this risk.
Corrects you on astigmatism at the same time as nearsightedness during LASIK or the PKR?
Yes, the astigmatism correction is "built" with that of myopia (or hyperopia according to the case).
What are the solutions for the senior astigmatismes to-6 diopters and associates to myopia?
Several techniques are theoretically possible, depending on your age, the origin of astigmatism (corneal and/or internal), in the presence of associated ocular anomalies, etc. For patients young, and including the cornea is sufficiently thick and regular (lack of Keratoconus beginner or turned out), a LASIK can be proposed; possibly need a touch-up because of the difficulty to correct this magnitude of astigmatism. You can also plan a surgery with the femtosecond laser (the same laser that cutting the flap of the LASIK) LASIK and relaxing incisions. As a first step, we realize the pre-cutting of the flap and the corneal incisions. The corneal incisions are placed on the meridians of the cornea more arched, in order to release them (the reduction of the curvature of the arched meridians can equalize totally or partially the meridians of the cornea curvature, and so correct all or part of the original corneal astigmatism). The effect of the cuts is less predictable than that of the excimer laser. In fact, it is better to observe the effect of these incisions and do not issue a correction excimer immediately. Based on correction of astigmatism achieved by cuts (these have the advantage of not "consuming" of corneal tissue), it is possible to correct secondarily by LASIK myopia and residual astigmatism (by lifting the flap that had been pre-cut at the incisions and using the excimer photoablation before resting the cover). For young patients, or who have a cataract beginning (and which is corneal astigmatism), a removal of the lens of the eye and a toric implant placement surgery (correcting astigmatism) is indicated.
In case LASIK surgery, the use of a personalised photoablation (e.g. treatment guided by the Aberrometry with iriian recognition such as Zyoptix) is recommended, in order to benefit from optimal alignment of the treatment (prevention of cyclotorsion)
After the PKR for myopia, I was told that my near vision would be less good. When should I see my eye doctor for a new prescription glasses? In other words my myopia will put how long to stabilize?
If has predicted you that the vision would be less good after correction of your myopia in PKR (it would be the same in LASIK), it's probably because you have reached the age of presbyopia (mid-40s). In this case, can be used in a first time of "Pharmacy sunglasses" (ex: + 1.50 D) to fend at reading, before final correction, after 3 weeks to a month approximately.
During a PKR ote epithelium after and practical excimer laser ablation, regrowth of the epithelium is she in contact with the ablatee area?
Yes, from the edges of the cornea, where the epithelium was not removed. Epithelial healing takes in a centripetal way. It is facilitated by the application of a lens, which insulates rubbing repeated of the posterior side of the eyelid during blinking. Remove the lens after 5 days or so; at this point, the entire corneal surface usually is re épithélialisée.
-What there is a more propitious season or avoid to operate of refractive surgery (LASIK, PKR)?
There is no season more than others, because the rules to be observed after refractive surgery are the same, regardless of the season. There are also surgical centers that are open all year round, and in areas with strong sunlight (Mediterranean basin, Florida, California, Mexico, Brazil, Near East, Australia, etc.). Only, it is important to wear glasses flitrants (index 3 minimum), outside when it is sunny, in the weeks following the surgery. Indeed, exposure to radiation in the ultraviolet (UV) and present in sunlight, is a source of possible inflammation at the level of the cornea. For the same reason, the use of tanning booths is very discouraged in the weeks following surgery to LASIK or PKR. Finally, remember that skiing is an activity at 'solar risk' for the eyes, and that rather it is inadvisable to leave before having let a month after surgery before heading to the snowy peaks.
Can you change the color of the iris following an operation of PKR?
PKR (laser surface for the correction of myopia) is a procedure which concerns exclusively the cornea, which is a transparent tissue. The eye color depends on the IRIS, which is not at all concerned by the intervention. There is therefore no reason so that the color of the eyes is changed after PKR or LASIK also. Remember that there is no safe and effective surgical technique to change the color of the iris of the eyes.
What's a patient myopia and far-sighted over 45 years with eye pressure at the limit of normal (between 19-20 mm hg) will achieve the myopia surgery?
The myopia surgery can be performed in presbyopic patients eager to gain independence in the glasses and lenses for distance vision. Regarding the eye pressure "limit", the figures you report are actually fall below the threshold chosen to define the presence of an ocular hypertonia (21 mmHg). Many parameters influence the measurement of intraocular pressure, starting with the thickness of the cornea (a thick cornea induces an increase in the numbers). The
theoretical risk would be to pass by glaucoma, the pressure figures tend to decrease after myopia surgery (LASIK or PKR). These techniques result in corneal thinning, which causes a reduction in the ocular pressure figures (this reduction being a priori "artificial" and related to the change of "resistance" of the cornea). However, screening for glaucoma is based on examinations such as the Visual field, the analysis of the morphology of the optic nerve head, etc. The completion of these examinations after the operation allows to detect glaucoma in time in a patient "at risk". The pre-operative balance sheet in refractive surgery sometimes allows to discover a beginner glaucoma in correction-seeking myopic. Under certain conditions, the operation of myopia can be performed in these patients, for which a regular follow-up (Visual field, OCT of the optic nerve) is then realized.
is there a link between cataract and eye color?
To my knowledge, there is no link between the color of the eyes (given by that of the iris) and cataract.
Hello, I currently have a myopia of-6 Dioptria with both eyes. I would like to have an operation but I was told that in some case the PKR could lead to hazes and regressions of sight. Is LASIK a better technique for strong myopies?
In theory, LASIK is actually increased for the strong myopia accuracy source, IE higher at-6 d (classically, myopia equal or greater to-6 d is considered to be a high myopia, myopia from-3 to - 6 d belong to the group average myopia, and lower myopia to-3D to the Group of low myopia). That said, the choice between LASIK and laser surface (PKR) is also dictated by variables such as the regularity and the initial thickness of the cornea. If one has advocated a PKR in your case, it is certainly linked to the fact that the cornea has a thickness and topographic characteristics considered incompatible with LASIK (risk of ectasia corneal post surgery). In this alternative, it is recommended to carry out the technique of PKR, which also gives good results for myopia of - 6 d. The risk of haze and regression (not the view but the correction, it's to say risk of light under correction) can be prevented by a suitable surgical technique.
Hello, I have blue eyes and pupils that dilate strongly in the dark. This combined pupillary dilation in my high myopia - 6.5 D and my astigmatism - 1 D, does me a bad candidate for LASIK?
None of the factors that you report is in itself a contraindication for LASIK. The color of the eyes has no particular effect on the result or the indication of the LASIK. Pupillary dilation is theoretically associated with a higher risk of postoperative halos, but some clinical studies have shown that the correlation between halos and pupillary diameter is rather low (or even absent!). Halos is however more risk to the degree of myopia to correct (in the case of myopia of-6.50 D, this risk is to consider: halos regress however with time). The most important to be able to perform LASIK is that your corneas are thick, regular, and free from ailments such as fruste Keratoconus.
Hello, I'd like to know why my myopia continues to increase while I'm 40 and my macula and my optic nerve are healthy, I asked the question to different ophthalmologists in my various consultations but so far got no clear answer.
Myopia is related to the fact that the plan of the "net" image formed by the cornea and the lens of the remote objects you look at is in a plan that is in front of the retina. In the plan of the retina (located back then), the image is blurry. Myopia is classically defined by a length of the eye (axial length) excessive. It is rare if not exceptional that the axial length increases as an adult (except in forms of evolutionary myopias called "malignant myopia", which start early in life and are very strong). On the other hand, the existence of a debutante cataract (particularly in its nuclear form: see https://www.gatinel.com/2011/01/quest-ce-quune-cataracte-nucleaire/) can induce the accentuation of myopia (called myopia of index). Finally, certain diseases of the cornea as Keratoconus may also cause a late evolution of nearsightedness (which is then accompanied by a strong astigmatism in general). In your case, therefore eliminating the presence of rookie cataract, which can be sometimes neglected and discreet to the review by the ophthalmologist. Myopia, repeated sun exposure, UV, smoking, etc., are risk factors for early cataract (sometimes from quarantine).
Is there a link between cataract and eye color?
No, no serious study has reported link between the color of the iris and the development of a cataract.
Is it possible to swim in the sea after LASIK surgery?
Yes, but it takes a few days (about a week), and preferably wearing glasses or a swimming mask if you open your eyes underwater swimming (this advice also applies to persons not made).
Is a myopia by excimer laser operation visible during a slit lamp examination?
(Biomicroscopy) slit lamp examination can observe the cornea under a high magnification. What about LASIK, this review allows to see the circular edge of the cover (and thus to suspect the realization of this surgery). Conversely, the PKR (techniques of surfaces) leave no detectable traces, except in case of specific scar phenomena (haze, etc.). In case of doubt, the conduct of a review of corneal topography allows better objectify surgery refractive (LASIK or PKR)-induced changes.
Hello, I am planning to have my myopia operated (medium myopia: OD:-4.5 (-0; 50) 0 °/OG:-3.25 (-0.75) 160 °). I would like to ask you 4 questions: 1) after Femto LASIK surgery, the flap corneal healing on average in what timeframe and is there any risk of remote displacement (months, years after surgery) of the flap If it healed well in post-operative? 2) after Femto LASIK surgery, it is obviously not necessary to rub your eyes in post-operative. On the other hand, is it possible remotely from the operation to rub the eyes in simple circumstances (when taking a shower for example, one often has the reflex to rub your eyes before reopening the eyes to remove the water, then rubbing with a towel to wipe your eyes) without any problems for the flap corneal, and if so from what time? 3) for medium myopia like mine, assuming that there is no contraindication to the Femto LASIK (no Keratoconus, thick cornea of more than 500 microns...), and that the 2 techniques are possible (PKR , Femto-LASIK), is there an interest in choosing Femto-LASIK rather than PKR if it is the notion of security which is the essential criterion of choice (by putting the notions of post-operative pain and the speed of Visual recovery at the second level)? 4) for a medium myopia such as mine (and always assuming that there is no pre-operative contraindications known for Femto-LASIK), is there still any risk of post-operative corneal ectasia or should this risk really be considered negligible or non-existent (this risk should be considered especially for strong myopia of more than 6D, for people with a thick cornea of less than 500 microns and for people with a frustrates form of keratoconus ) ? Thanking you for your answer. Kind regards
Here are answers to the 4 points
(1) after refitting the cover, the healing of the edges takes about 24 hours. Remote move risks are very low. The reported cases concern significant eye injuries (punch, projectile, etc.).
2) at A distance from the intervention, simple rubbing (MOP, wipe, remove makeup) is not likely to move the flap .
3) if safety is your essential criterion, PKR is, at least in theory, the safest technique since there is no creation of flap or interface. The LASIK more solicits the corneal biomechanics. The dry eye is slightly more pronounced in LASIK than in PKR in post-operative. That said, if your corneas are compatible with the realization of LASIK, there is no reason to refuse this technique because the complication rate is extremely low in refractive laser surgery (provided to eliminate the bad candidates, and to use high-performance hardware). The choice between these two techniques belongs to you!
4) the thickness of the cornea is only one of the explanatory variables with regard to the risk of post-LASIK ectasia. Other parameters such as regularity of curvature, posterior curvature, Central thinning speed, etc. should be incorporated. If your corneas are "normal" (no Keratoconus frustrates in view of the maps of corneal topography and corneal thickness), and that a sufficient posterior residual wall is preserved (250 microns and more), then the risk of ectasia can be considered as zero. Millions of LASIK procedures have been completed for about ten years. The proportion of ectasia is difficult to measure, but is very low. Most of the case of ectasia reported are often related to the presence of an undetected ecstatic (infra-clinical Keratoconus) pathology. The case "unexplained" ectasia are even more exceptional.
What could be the reasons for an inability to properly ask ring sucking on an eye with consequence to interrupt the LASIK surgery?
The suction ring helps to immobilize the eye during the making of the cover of LASIK (whether with a femtosecond laser, or a mechanical microkeratome). The dimensions of the ring vary from equipment to another, but the diameter of this device is around 2 cm approximately. He must come in contact with the eye and therefore cross the eyelids, which are maintained by an instrument called a blepharostat. Some conformations orbital and palpebrales sometimes make it difficult if not impossible the laying of the ring; Oriental eyelids (Asian patients) are, for example, tighter than the Western eye. If this type of conformation is the fact that the eyes are "recessed" in (enophthalmos) orbits, laying of the ring can be particularly difficult. Regardless of the orbital characteristics, some eye features make it harder to laying the suction ring. o-rings and/or flat corneas (corneal astigmatism). It is likely that these eyes have a bad congruence with the ring, for anatomical reasons.
Is the sea forbidden after LASIK?
Water sports are perfectly compatible with the realization of a LASIK. Course wait a few days after the completion of the operation, and wear good sun protection (glasses of filtering UV) and/or swimming goggles. Actually, the intervention distance, no activity is prohibited to the LASIK operation, except for vigorously rub their eyes!
All hypermetropes are operable and, if so, at what age?
The correction of hyperopia can be performed mainly either by the cornea (LASIK) surgery, implant surgery (extraction of the crystalline lens and replacement with an implant whose power is calculated to correct hyperopia - biometrics). The choice between these indications depends on various parameters: the age, the degree of farsightedness, the presence of a debutante cataract, etc. Schematically,
1) in a patient less than 50 years of age (approximately), LASIK surgery is preferred, at least for hyperopia less than 5 dioptres (approximately). If the hyperopia is more important, a partial correction can be discussed (interest in patients who have to show less than some correction for their job for example). The legal minimum age for the realization of LASIK surgery is 18 years, but it is preferable to wait a few years to operate, the hyperopia can sometimes evolve during the 3rd decade;
2) in patients aged 50 and over, LASIK remains elective, in the absence of cataracts and for low and medium-sized hyperopia. If the hyperopia exceeds 5 D, the Crystalline lens (cataract) is potentially interesting: there is no theoretical limit of correction, and the placement of multifocal implants can even allow the patient to reduce his optical correction in glasses by far and close. The surgery of the Crystalline lens is more "invasive" than that of the cornea since it is intraocular. The biometric calculation must be carried out with formulas adapted to hypermetropic eyes (short eyes).
Can I postpone lenses after surgery of myopia in the case of sous-correction (horny fine and strong myopia - 6 d)?
After surgery (LASIK or PKR), the existence of a under correction myopia can cause a patient to see a lens correction, for some particularly demanding activities visually (driving, show, etc.). The port of lens is not against stated, but as the correction is often moderate (ex:-0.50 D), it is better to keep a pair of glasses on hand, which will only be worn intermittently. If lenses are prescribed, it must also take account of the change of radius of curvature of the cornea.
At you one more problems of the type: drought, halos, red eyes..., if one has enough dilated? The operation is it discouraged?
The dilation of the pupil is a physiological mechanism. If darkness, must be for the eye to collect more light (photons). Some patients think they have particularly dilated, while it is an "illusion" related to the blue color of the iris. Sometimes, it is actually a diameter pupillary greater than average, and in this case most of the studies show that there is no additional risk of luminous halos (dryness and redness of the eyes have nothing to do with the diameter of the pupil). On the other hand, the degree of correction is correlated with the risk of halos. Thus, a strong myopic with a diameter of standard Pupil has more risk of seeing halos in the postoperative period, as a slight myopic whose wards tend to expand strongly in the Dim light and darkness.
Hello, what is the cost of a myopia operation? What about a pre-op consultation? Thank you.
I was operated on a strong myopia by PKR and practicing basketball. Risks associated with shots in the eye increased by the fact that my cornea is finer than before? Is it advisable to wear eye protection and where can I find a suitable pair?
Of PKR to reshape the surface of the cornea without completed prior cover cutting, there is no particular weakening towards suddenly, or "fingers" in the eye. That said, it is always preferable to limit the risk of ocular contusion in general, so wearing protection glasses (fill you with your optician) is recommended in all cases if you are at risk for eye bruises.
I had surgery by PKR bilateral, is it normal that I could not open my eyes 1 day after?
Yes, for the healing of the corneal surface (skin regrowth) is not over the day after the operation. Generally takes two or three days to be able to open your eyes more comfortable.
Hello, after review I can have surgery myopia (-1.50 to each eye) by the two techniques: PKR or LASIK. My eyes are a little dry (not a lot of tears) and especially I "cozy". Also what is the best technique for me? Furthermore I work all day on computer (approximately + de7h on pc) what is the best solution for fast Visual recovery (recovery of quick work)? Thanks a lot for your answer.
A pre-existing dry eye surgery can preferentially oriented a PKR, which generates less dry eye in post operative. It all depends on the degree of dryness that you present (a moderate drought is not a contraindication for LASIK, at least as long as it is not complicated to dry keratitis, etc.). -1.50 D, LASIK and the PKR will give an equivalent Visual result. LASIK allows a faster Visual recovery, and causes no post operative pain.
After surgery to Lasik for presbyopia and hyperopia, is it common that after almost 3 months, the vision by far is still not at the level of the expected result (9 tenth). The vision of almost being very satisfactory.
The realization of a correction of presbyopia and hyperopia in LASIK is based on the induction of a multifocalite, and sometimes to a difference of correction between the eyes (one eye is corrected ISO, the other closely). Usually, the Visual recovery is far slower than closely, but after 3 months, changes to wait are generally low. An editor can then allow to give a gain in distance vision.
Hello, thank you for this site. I have two questions:-in what case does the surgeon place on the eyes a healing lens after surgery, instead of a simple eyedrops for the following week? -Is there an attitude to adopt, in the long term, to preserve as much as possible a new reduction of vision, for a medium to strong myopia successfully operated, outside of the sunglasses. Should we limit the occular fatigue (reading and computer) or is it not directly linked? Thank you
The pose of a contact after refractive lens is not a requirement, but it seems recommended after PKR (surface laser) because some studies (my experience) shows that it reduced the pain post PKR and allows a faster epithelial scarring, protecting the corneal "laserisee" of the action of the eyelid surface including. A lens after LASIK may be interesting to protect the surface of the flap and accelerate the healing of the edges of it, but for a shorter period (24 h vs 4 or 5 days for the PKR).
In order to avoid a loss of vision (myopic recidivism), it is indeed necessary to wear sunglasses outside, and not to rub the eyes vigorously; I do not know any other methods than these.
How long must your bandage after lens wear the PKR?
To wear these lenses on a continuous basis between 4 and 6 days after the completion of the PKR.
How long should I wear the bandage lens after a PKR (surface laser)?
The port of the bandage after PKR lens is about 4 to 5 days. This period allows the epithelium to heal and cover the entire surface of the cornea to which it adheres. Do not remove and replace the bandage lens this time.
For more information on the suites after PKR: https://www.gatinel.com/chirurgie-refractive/suites-operatoires-apres-chirurgie-refractive-laser/suites-operatoires-apres-pkr/
3 weeks after my surgery my astigmatism in the femtolasik my vision is still blurred. Is this normal when can I have a clear vision? Thanks in advance
It is difficult to answer your question without knowing certain details such as the degree of correction made, and the objective degree of "blur" (Visual acuity without correction, etc.). In general, recovery after correction of astigmatism is longer than after the myopia surgery (with or without a little) of astigmatism. After three weeks, the evolution can be favorable; It should also be to eliminate a problem not directly related to the correction of astigmatism as dry eye, which can cause a decline in vision in post operative. If the drought is concerned, more intensive treatment of it (instillation of artificial tears) can bring an improvement fast (but transient if you waive regularly moisturize your eyes). Finally, if the vision remains fuzzy, conducting an assessment of Visual acuity, a corneal topography and an aberrometrique review is expected to slice and the diagnosis of slot correction, etc.
Hello. A month after my surgery to the femtolasik to correct my astigmatism, my vision is still blurry and my eyes are dry. Is this normal?
Dry eye after LASIK is classic. It may result in a temporary decline in Visual acuity. Regularly use artificial tears to improve the State of the ocular surface. Furthermore, the correction of astigmatism usually results in a slightly more late or extended recovery than simple myopia correction.
I just did a PKR PTA + 1 left eye crosslinking. We are in 5 days and I see a blur (near and far). Whereas before I was corrected to 7/10. Can this go term?
The indication of the crosslinking reflects the fact that you had to introduce a beginner form of Keratoconus at the level of the left eye. Joint cross-linking and the PKR remains controversial, and has not made sufficient to ensure efficiency in the medium term. The only achievement of the cross linking generally causes a decline in vision after the procedure (the maximum number of tenths decreases even with a correction), because the removal of the epithelium unmasks part of the irregularity of the cornea, and the application of UV radiation can induce a reduction in transparency of the cornea (this reduction may be increased in case of simultaneous PKR). The cross linking is currently under FDA studies in the United States, or the procedure is not yet validated. Moreover, this technique is not intended to see, but stop or slow the progression of Keratoconus. In principle, over time, your vision should improve through the epithelial remodeling.
Hello, is it possible to go skiing 1 month after surgery to LASIK because of the high mountain light?
The practice of outdoor sports such as skiing, boating, etc. is possible a month after LASIK: However, it is necessary that you wear a correction by filter glasses (sunglasses), designed for the Assembly, and index 3 (see 4, although this category is not compatible with driving). Early and intense exposure to UV (ski, beach, nautical activities, but also on tanning booths!) is a factor identified postoperative inflammation (keratitis), regression of refractive effect after corneal surgery for myopia correction (LASIK, PKR, etc.).
When an eye doctor delivers us a prescription for the glasses:. OD = 0.75 and OG = 0.75, what do these numbers mean. The vision is how in this case? Thank you
The OD and OG mentions of course match the right eye (OD) and the left eye (OG). The figure (here 0.75) represents the Dioptric power of the corrector bezel glass. In your case, the correction between the eyes is the same. Initially, the lack of sign suggests a positive correction, and in the absence of further clarification, correction is for vision by far. It is therefore a farsightedness which is moderate here.
Five weeks after a correction in the femtolasik my eyes are dry. Can I use saline to hydrate and does have a positive effect?
It is normal to dry eye after LASIK. The regular instillation of saline (or gels, wetting agents, etc.) is recommended (not), and can have a beneficial effect on vision.
How can we without astigmatism with a vision of 4/10 to a myopia of-4 D after surgery on the femtolasik gives me a blurred view and that has worsened compared to what I had before the operation. That is he spent the just .can you fix? 5semaines after this surgery my vision can still to improve?
It is difficult to answer your question without knowing some elements such as the type of astigmatism present (myopic? hypermetropique? etc.) and the existence of possible per (during) or post operative complications. Should be discussed with your surgeon who has to practice a corneal topography and a review aberrometrique to document this development which is actually not a usual after femtoLASIK.
Can you drive after biometry of the eye
Biometrics is the calculation of the power of the implant in cataract surgery. This review is made most often by interferometry, and without contact with the eye (or expansion). Therefore, it is perfectly possible to drive after a biometry of the eye.
I have to have surgery for cataract with as Lentile intra ocular Restor multifocal implant. The laser surgery for myopia that I got 3 years ago, can harm has this choice?
The intra ocular Restor lens is a diffractive lens bifocal. In your case, the antecedent of refractive surgery for myopia can cause two problems:
-an error in calculating the power of the implant (whether monofocal or bifocal does not change the risk of error). It is imperative that your surgeon uses a method of calculation (biometric formula) adapted to this situation, and that the measurement of the corneal power is just
-the presence of a cornea irregularity (sometimes increased after myopia surgery) could induce a reduction in the expected performance of the Multifocal Lens.
In principle, in your situation, the realization of a corneal topography has to be carried out in order to accurately measure the corneal power, and eliminate too much irregularity related to the action of the laser.
What is the minimum age for an epi-lasik? I have 20 years is a little young for?
The minimum age for any refractive surgery is legally set at 18 years. This age is not necessarily the age from which it is advisable to do the surgery. Epi LASIK part of excimer techniques tell surface (variant of the PKR). It is especially important that your myopia is stabilized to consider intervention, because it does not prevent the development of myopia if it is not completed. Of course, there are the rest of the record does not reveal of contraindications to surgery.
I'm farsighted with a correction of + 2D, I have 30 years, and given the low level of farsightedness must he wait a few years, my view drop further to the operation with the laser or the operation is already justified?
Surgery for a farsightedness from + 2 D can be considered at the 30. Most of hypermetropia of this age can live without glasses, but at the price Visual effort, headaches, and a growing embarrassment to the vision closely. Also, the realization of a LASIK (technique of choice in this context) can improve the distance vision and relieve the patient. Hyperopia sometimes tends to increase over time, because it is "offset" way permanently by the patient, which made "efforts accommodatifs" (efforts in principle reserved for near vision) extended, which persist during the eye exam and induce an under-estimation of hyperopia. Examination under "cycloplegics" (drops that paralyze the accommodation and also dilate the pupil) allows to measure total hyperopia (latent). In your case, it is possible that this farsightedness, measured under cycloplegia, is greater than + 2 D (ex: + 3.50 D). That said, the correction should not be complete but one that gives you subjectively good comfort (without cycloplegia). In the future, the reappearance of a farsightedness (corresponding to the "latent" part, either + 1.50 D in our example) will be subject to a secondary correction as needed.
Hello, I have a strong myopia or hyperopia in 50 years since a young age. After review it tells me that my cornea is thin and so impossible to do LASIK, the solution is the implant phakic! Why?
First of all, you can be both myopic and farsighted, but one or the other. The correction of myopia laser requires to "dig" his Center. It is easy to calculate in advance how much the laser must remove to correct the optical defect that is considered. If your cornea is too thin, there may not be enough thickness to deliver the required correction. If we did, your cornea is too thin and could deform secondarily (ectasia). However, the placement of an implant phakic (without removal of the cristalln) allows to correct all of the optical defect in cases like yours.
In the case of intervention by lasik laser femtosecond to correct a presbyopia, hyperopia and astigmatism (57 years), is it operate both eyes at once or each a few weeks apart?
In general, the correction of these abnormalities by LASIK is performed in a single time and for both eyes at the same time. However, your correction may encourage the surgeon to make sure of getting a good correction on an eye before operating the other. Similarly, a recovery on one or the other of the two eyes may be necessary to refine the correction a few weeks later.
Hello. I have two questions for you: 1) in case the ophthalmologist would have badly measured myopia, there are t - he a reverification of myopia in the pre-operative consultation? Or operation based on the ophthalmologist measures? (2) on what timescale can be based that myopia is stable? (3 months, 6 months, 1 year, 3 years..?)
The operation of myopia is based on measurements made during the pre-operative consultation, and in no case on the ophthalmologist measures alone. Measurements carried out by the city ophthalmologist to check the stability of the myopia. There is no specific time scale to estimate the stability of myopia. Classically, it is estimated that the absence of evolution on a year allows the diagnosis of stability. That said, strong myopia tends to evolve on a longer period than low myopia, and the patient's age plays a role in the stabilization of myopia.
I have a thick cornea and refractive surgery for myopia is achievable. However in a last inspection we realized that I would have a more curved than normal cornea and that it would be may be a form of Keratoconus. Is that you already had a similar case? Is the surgery an option?
The screening of Keratoconus is a crucial time of the preoperative examination. It is accomplished by conducting a topographical examination (corneal topography). There are several types of topographic examination. The measure of the curvature of the cornea is not the only criterion to inspect. There are more curved than normal corneas that are not reached Keratoconus, and conversely, corneas rather less curved than the average and who are living with some beginner forms of Keratoconus. The diagnosis of Keratoconus, to also take into account the thickness of the cornea (product), the variation between the Center and edges (tomography), the appearance of the back ("inner" side) of the cornea. These data are measured by topographs such as the Obrscan, the Pentacam, etc. In some cases, the measurement of the biomechanical properties of the cornea (ORA, Ocular Response Analyzer) can bring an additional argument to the diagnosis of Keratoconus. In the event of proven Keratoconus, LASIK surgery is prohibited. In the case of very early and, stable form of KC (infra clinical Keratoconus, suspicious stable form or fruste form), the realization of a PKR (surface laser, without cover) can be discussed according to the degree of myopia and astigmatism to be corrected, the age of the patient, etc.
I have 69, an early cataract for 1 year, I am farsighted and astigmatic, can you consider to deal with the problem set?
Cataract surgery is to remove the clouded lens (cataract) and replace it with an implant. To correct hyperopia and astigmatism, please choose a toric implant, whose power will be calculated to correct hyperopia, and the toricite adjusted for your astigmatism correction. Thus, cataract, hyperopia, and astigmatism will be corrected. It is even possible, in the absence of complications, to correct near vision using a toric multifocal implant.
How can refractive surgery modifiy the refraction of the eye? What is this change occuring in the refractive medias of the eye?
Refractive surgery uses different physical principles to change the refraction of the eye and correct a refractive defect. The most widely used principle (it's the eyes among the most frequently performed surgery) is to change the optical power of the cornea in by changing the curvature. Indeed, the optical power of a lens depends on its curvature, and its refractive index. Currently, there is no common technique to change the index of refraction of the cornea. On the other hand, excimer laser sculpture made in LASIK or PKR allows you to change the curvature of the cornea (the laser delivers a "Remove profile" adapted: see the following link: https://www.gatinel.com/recherche-formation/profils-dablation-laser-excimer/)
Other principles may be used, such as the addition of a refractive implant (artificial lens), or replacement of the Crystalline lens natural by an implant of Crystalline lens artificial, whose power is calculated to correct the pre-existing optical defect (this calculation is called biometrics).
Can presbyopia be corrected through LASIK?
To be fair, true correction of presbyopia based on the return of an accommodation (ability to focus close eye). Presbyopia is precisely defined by the installation of a reduction of the accommodation. However, there is no proven technique to make lost accommodation. LASIK allows you to 'compensate' presbyopia by two types of strategies: (1) the monovision, where one eye is corrected for vision from afar, one for near vision. This technique requires some "adaptation", but it is possible to simulate it by wearing contact lenses. (2) the multifocalite, which aims to increase the depth of field of the operated eye, so he could see "at once" from far and near. It's a trade-off between light degradation of distance vision and near vision increase not corrected. "presby LASIK" is a technique that uses the effects of some laser ablation profiles to increase the depth of field of the operated eye. It works well in farsighted patients. For short-sighted, presbyopia is more easily offset by monovision in general.
Is it possible to have surgery for myopia and presbyopia at the same time without resorting to Monovision?
Apart from the techniques based on monovision (one look dedicated to the vision from afar, the other closely), the multfocalite allows to compensate for presbyopia (the far and near vision is provided to each eye: multifocal implants, presby LASIK, etc.). Monovision is generally better tolerated in short-sighted as the "multifocalite". For the "small myopic" (-0.50,-0.75 D), implantation of the KAMRA inlay seems an interesting technique, however resembling a monovision which degrade less distance vision.
If we do operate in the excimer laser for myopia (with laser femtosecond to the cutting of the pane), in the case of sous-correction, can we redo surgery by the same technique to improve the result?
The technique that you made allusion is a 100% laser LASIK (the cover to the femtosecond laser cutting, then sculpture of excimer laser corneal dome). In case of correction, it is best to resoulever the flap and deliver additional correction. It is not advisable to rejigger a second part. Indeed, the first part can be easily re raised by an experienced surgeon (this component "sticks" to the cornea, but it is possible to find the plan of separation). In addition, a redecoupe femtosecond laser exposed to certain risks, such as the occurrence of micro pleats or inflammation of the interface. Finally, the realization of a recovery for slot correction necessary that the "posterior residual wall" has a sufficient thickness. This thickness is dependent on the thickness of the cornea, the thickness of the original cover and the importance of output correction.
I am surprised your answer as to the sustainability of the effects of the operation of myopia. Operated for 4 years, my view has been deteriorating for about 3 months. In talking around me, many people have faced this fleeting effect, some have been reoperes, others again wear glasses. What is the reality of this phenomenon? Is there an interest to operate again? More chance of stability after a second surgery? Thank you
It is tempting but difficult to extrapolate a statistical truth from a personal observation, even if it can be shared by other people in your life; myopia surgeons know that the vast majority of the patients operated are no recurrence of myopia in post operative. Otherwise, the rate of "recovery" would be higher than the 5 to 10 percent on average in the series published, and our operating programs (and waiting rooms) would be filled with patients for surgery after a few years of practice. That said, there are specific risk factors that expose some patients to a (partial) return of myopia (the degree of recurrent myopia is often lighter, in any case less than initial myopia: a slight same myopia, however, is penalizing for Active patients). These risk factors are for the main: the high myopia (greater than 6 D initial correction), young age (ex: less than 22 years before the first intervention), solar exposure chronic and prolonged, the presence of certain features eye (cornea more flat than the average prior to intervention), etc. The PKR more exposed to a myopic recidivism than LASIK for high myopia (superior to-6 d). Pronounced astigmatism associated with myopia is also source of frequent regression.
To re-operate, certain points must be checked, such as the absence of complications (ectasia), or the occurrence of a myopia of index (myopia linked to the occurrence of a nuclear-type cataract, see on the site). The realization of a recovery does not expose to a risk of reoffending particular, when this recovery is indicated and achievable.
Hello I have to have surgery soon to my myopia and astigmatie. I apparently have a strong myopia and my surgeon is going to use a product (discharge has sign) because the effects in the long run on this last not including not known. Can you tell me more because I don't was told of this product during my visit to the secretariat.
It is difficult to guess the nature of this product. In principle, if you participate in a clinical trial, you must receive explanations on the nature of the protocol used, the risks involved, etc. regarding the realization of high myopia surgery, it is not necessary to use special "products" If your operative indication is valid. I advise you to take appointment with your surgeon for the explanations you want with respect to this "product".
I'm having surgery cataract soon, having had surgery for myopia laser for about 4 years. The result of the operation is the same as those who never underwent the laser? There are t - it a particular lens choice?
The result of the cataract surgery for an eye surgery myopia is the same. It is just that your surgeon pays particular attention to the calculation of the power of the lens (implant) ocular intra. "Classic" formulas do not always work, so use appropriate formulas. The choice of the lens can be influenced by the presence of certain aberrations at the level of the cornea, the existence of a residual corneal astigmatism, etc.
Hello, is the recoil on LASIK technology enough to be sure to assert that in a few decades there will be no incidence of the operation (cecité, degeneration of the cornea, etc...)? If so, what arguments can be asserted that no part of the eye may degenerate following this "unnatural biological modification" of the cornea?
LASIK is a technique the first cases had been made in the early 1990s: the decline is currently much higher than 10 years (over 20 years). For the moment, no degeneration were observed. LASIK is that the cornea, so there is no risk for the other structures of the eye. Finally, some interventions, most "traumatic" for the cornea than LASIK as total or partial of cornea transplantation have a very large recoil (50 years plus), without complications.
What is astigmatism since forever or can we become for example to 70 years
Astigmatism can be congenital (astigmatism associated with a "distortion" of the cornea) or acquired: diseases of the cornea (Keratoconus, pellucid degeneration) cause the appearance of a later astigmatism. Cataract may cause the appearance of an "internal" (cristallinien) says astigmatism. Complicated cataract surgery can also cause the appearance of astigmatism.
I have 33 years, my correction is OD-0.75 (-3.50) 120 and OG + 3.00 (-2.75) 70, I also have a strabismus converge on l, OD. I would like to have surgery knowing that my correction evolves slightly every time I go to see the ophthalmo every 2 years. Is the operation feasible as well as for strabismus? Will cataract surgery be possible later if I have surgery now?
In general, we prefer that the correction is stable to consider an intervention; If the correction is not stable, it must also eliminate the presence of corneal pathology as beginner Keratoconus. If the correction is relatively stable and there is no problem-corneal or other complications, then it is possible to envisage an intervention of refractive, followed by surgery for strabismus correction. Cataract surgery is quite possible after correction of astigmatism.
I suffer from a so-called "slight" myopia requiring the wearing of daytime lenses and spectacles in the evening, and I still claim the intervention? Should I go through my doctor ophthalmo to decide on the relevance of the intervention? Moreover, although I am a nurse, I am extremely anxious, do you administer premedication before this procedure?
There is a legitimate desire for intervention regardless of the degree of myopia, if you want to get a clear distance vision without glasses or lenses. The effects of the intervention on the near vision can be discussed from about 45 (presbyopia appears around this age and led not nearsighted patients - naturally or after intervention - to postpone a correction close). In some cases, the possibility of unilateral action can be discussed (monovision), in order to maintain a near vision not corrected on one side at least. A pre medication is administered before surgery. If your ophthalmologist doctor does not a priori against refractive surgery (or is not on the contrary too proselyte in this topic), then you can discuss way lit up with him; Depending on your motivation and the condition of your eyes, it can help you advance your thinking.
I would like to know why a person who has corrective glasses against myopia sees his view degraded (by these same glasses) near vision when she becomes long-sighted? That is to say that it reads better without the glasses.
The myopic eye is an eye too long: the images of distant objects that are formed on the retina are blurred, but those coming from closer targets are clear. A-3 dioptres myopic sees net without glasses to 33 cm, and blur to the beyond. When he wears his glasses, he is corrected for distance vision, and must accommodate to see net. Arrival of presbyopia, there has been a reduction of accommodation, but the myopic, by removing his glasses, can benefit from a near NET vision without effort.
More information on this page:
I would like to know if with a very strong myopia (-18.5-19 D), I can be made, and if after the operation I am not corrected to 100%, I wear glasses or lenses to improve my vision?
Your myopia is very strong. He's not possible to fix it completely with a technique of LASIK, or PKR. Surgery with implantation of a lens (phakic implant) ocular intra or surgery of the lens with replace it with an implant are possible a priori. The total correction is possible, and if this were not the case, a further correction in glasses is quite possible.
Hello, I want to know if the excimer PKR surgery we can then identify the operation without seeking it with a background of eye? After 2 months of operation.
The intervention of PKR is often difficult to detect by a simple review of the eye to the biomicroscope. The examination of the fundus is the retina does not analyze the cornea However, a review of corneal topography may allow the detection of an operation from PKR (flattening of the Central curvature of the cornea due to the remodeling done by the excimer laser).
What are the post-operative risks of a PKR intervention? Can I resume work 2 days after my operation?
You can find information on this page, about the risks of the PKR:
A recovery to J2 is theoretically possible, but it is best to wait at least 3 or 4 days.
I wanted to know if there is an optimal period of time to perform a touch up after a multifocal femtolasik operation? three months after the operation the vision from afar can - she still improve?
3 months is minimum, but may be sufficient to accomplish a touch-up. The vision can be improved even late, but this depends on the reasons for the lack of vision.
For a surgical correction of presbyopia, results are they permanent or should anticipate a regression of the effect after a few years?
It all depends on the technique of surgical correction used for correction of presbyopia, and the age at which the intervention is accomplished (presbyopia evolves between 45 and 60 years approximately before stabilizing). Techniques that are based on the use of implants are able to correct presbyopia in a sustainable way. In contrast, surgical laser (LASIK), the possibility of an even late regression of the printed effect initially cannot be excluded. The correction with implant KAMRA is also designed to be sustainable and correct presbyopia full time.
The ophthalmologist told me that for my very high farsightedness implant can be interesting but that the operation is very heavy, is it true?
Implant placement for the correction of hyperopia generally consist of a "cataract" surgery: replacement of the lens by implants: this intervention is "heavier" than the correction laser (LASIK), but not more than the intervention of cataract. It is shown from 50s, at the strong farsighted (more than 6 dioptres), especially when there is a beginning of cataracts, or the anterior Chamber of the eye is particularly narrow, which exposed to a risk of acute glaucoma. Apart from these indications (young patient), it is often preferable to postpone surgery and fit contact lenses.
Hello, the use of monovision (myopia and presbyopia) has t - it is not an effect on the assessment of the reliefs? Thank you for your answer
Indeed, the depth perception is based on the difference in point of view of the eye right and left eye: it implies as well that the sharpness is sufficient and equivalent to each eye. Corollary of monovision, which is based on the induction of a vision not corrected by far on eye, and induction of a vision uncorrected on the other is an "imbalance" in distance vision. However, the feeling of relief is provided by the brain (the Visual centers), and some patients operated of monovision will acclimatise well the difference of correction.
Hello, I was treated in PKR in 1993 for 2 eyes, and airbrushed in PKR in 1999 on a single eye. I've never done the 2nd but the vision gap is important so annoying. LASIK will be possible after a PKR 1st generation?
In theory, a LASIK is possible after PKR, provided that the thickness of the cornea is sufficient to cut a pane (hood) and treat residual myopia. The realization of a LASIK after PKR exposed however some complications, such as the occurrence of inflammation (keratitis of the interface) interface. Despite any comfort that can bring a PKR, it may be preferable to operate again you with this technique. These councils depend of course the result of your exams (corneal topography, residual myopia, etc.).
I had surgery 13 years ago by lasik I have to have the surgery of cataract eyes 2 in a week my eye doctor told me that the calculation of the correction is more complicated if the correction made is not good can we bring a further correction by laser or can we change the inadequate implant?
Actually, the "classic" formulas for the calculation of the power of the intra ocular implant are not always adapted to the operated eyes of refractive surgery. In the case of a correction error occurred, it is at least theoretically possible to fix this error on the cornea (resoulevement cover LASIK and additional laser treatment).
Hello, what is better control risks associated with the long term evolution (after 15 years) of the lasik surgery at the time where we practiced the radiaire keratotomii in the 1990s?
LASIK now enjoys a decline for 20 years. The principle of the correction is very different from that of the radiaire keratotomii, which was based on deep incisions (90% of the thickness of the cornea) inducing significant biomechanical changes. This is not the case of LASIK; refractive stability achieved by this technique is much higher.
Can we bathe in the sea with eye implants?
Swimming in the sea or in the pool with intra ocular implants is quite possible after the period post surgery ended early.
I have been prone to ophthalmic migraines for a long time. does a PKR or LASIK intervention risk bringing them back, accentuating them, or can it more generally have an impact on this phenomenon?
Initially, the PKR and LASIK have no effect on the occurrence of ophthalmic migraines.
Hello, what is after laser cutting, the cover adheres perfectly and in what time frame? Thank you
LASIK with (femto LASIK or LASIK 100% laser) laser cutting requires a period of attention from 24 to 48 hours, during which the adhesion of the flap is not yet complete. In the past, the membership is enough to make face gestures and other circumstances of daily life. It is not recommended to rub their eyes after LASIK, and even in the past, for reasons "biomechanical" this time.
Hello, how long after the operation of surface laser then I redo of the sports (racing) thank you
After surface laser (PKR), resumed sporting activities such as running or fitness takes about a week.
Hello, how long after the operation of surface laser then I redo of the sports (racing) thank you
It takes a week to be able to resume this type of activity in good condition after the operation of surface laser (PKR).
Hello, for monovision, are there not a degree of chance in the choice of the sous-correction. What is monovision is also valid for a not yet presbyopic patient?
Monovision, the choice of the degree of monovision is the result of several parameters; the age of the patient (its degree of presbyopia) and tolerance away from correction (that you can test in lenses to simulate the result) are the main. Monovision is possible not presbyopic patients who wish to anticipate the effect of future presbyopia. Monovision is a source of some visual effects more or less troublesome according to patients, that is why it is necessary to check the tolerance of this before surgery whenever possible (ex: test in contact lenses).
Hello, is it normal to have a veil on the eye more than 10 days after Lasik? What is - that because of this veil? Thank you
The appearance of a Visual veil after LASIK is several possible causes. In the first place, some degree of dry eye are after LASIK: If this drought is marked, it can induce a feeling of sailing (bad quality of the tear film, keratitis, etc.). More rarely, an inflammatory reaction of the interface can also induce a 'veil' Finally, always check the microphone folds of the cover, which may also cause a veil, even if in this case, other symptoms are frequently associated (vision split, etc.).
For subjects with high myopia (-7 d in the two eyes), the LASIK surgery does not always allow to find a sufficient correction for daily activities. The correction for residual myopia after surgery can be done with standard lenses or should we wear special lenses (more expensive) which require specific operated corneas curvature measures?
-7 diopters in LASIK correction may be complete, provided that the original corneal thickness is sufficient. For example, a cornea of 550 microns, regular, to consider a total correction of this degree of myopia on a comfortable optical area, provided they achieve a corneal flap relatively thin (ex: 120 microns). However, statistical studies show that the risk of sub correction is actually primarily related to the degree of initial correction... Thus, it is legitimate to anticipate the possibility of a correction to the correction of high myopia (>-6 d). If the residual corneal thickness allows an editing can be performed (relift of the flap). If this editor is not possible, then a lens adaptation is possible (large radius of curvature lenses: lenses "standards" adapted to the flat corneas may be sufficient, if the final keratomery is not too small, which also depends on the initial keratometry). In general, the correction is low, and gene especially in special circumstances (eg; night driving). As a result, operated patients correct in glasses as needed, and intermittently in contact lenses.
Hello, at age 46 I have an excellent view from afar and at least two in presbyopia. Is operation for presbyopia not recommended in this case, there was a risk of degrading vision by far?
To specifically answer your question, know your correction by far. The correction "minus two" you mention is not a correction for presbyopia, but myopia (sign less characterizes the corrections for myopia, so that corrections for presbyopia is expressed by a positive addition). If your correction for presbyopia is + 2 diopters (and not minus 2), it must be recontrôlée, because at age 46, the usual addition is + 0.75 + 1 D D up. It is possible that you have a slight hypermetropia (+ 1 d), that you do not correct but the correction (+ 1 d) should be added to that of presbyopia (adddition + 1 d) night so in total + 2D. This type of farsightedness is usually not felt as awkward by the patient, but his correction can improve the distance vision. In your case, if but such is the situation, a surgical correction of presbyopia is possible, but it will involve a more or less significant reduction in the uncorrected vision by far. A correction of type LASIK with slight over-correction on one side, and correction of hyperopia (for far vision) may allow you to reduce your dependence on glasses in vision; start by checking your refractive status with your ophthalmologist.
It is even more difficult for the patient to make his choice between the PKR or lasik that opinions differ between surgeons. For some, the PKR is adapted to a nearsightedness light to medium 3 d max., for others, as you, 6 d max. What is the risk of inaccuracy of the result increases with the number of dioptres to operate?
Most in refractive surgery and equipped with gear recent laser surgeons consider that the PKR is well suited to the correction of low and medium myopia (up to 6 diopters about). The risk of imprecision is low so far, but then increases (from 6 D and more). In my experience, the PKR is a reliable and effective technique beyond 3 dioptres; from 6 diopters, the risk of sub correction (healing regression) is higher than in LASIK.
Hello, by the preoperatoires for a lasik tests, the test of the retina has revelle 2 small holes (1 on the top, the other down on the same eye) who come to be mouths by laser.le doctor pushed back the date of l ' operation Lasik has 15 days healing time. What do you think. Thank you
It is a logical attitude: LASIK will be then priori innocuous with respect to these peripheral retinal lesions
Hello, following lasik surgery, me has been found dirt under the hood. The latter cause me a sort of veil in front of the eye. Are they going to go alone or will t - we re - raise the flap to clean? (If yes how does t - he?) I said that I had surgery it more than 3 weeks ago. Thank you.
Evolution is conditioned by the nature of these deposits: If the presence of foreign bodies is well tolerated in the interface of a flap of LASIK (and not collected by the patient), it is best to remove them if their presence has an impact on the vision as in your case. Sometimes, these impurities are epithelial cells of the cornea (epithelial invasion). Epithelial invasion can stop to her - even and regress in time. If your Visual symptoms persist, it seems logical to perform a cleaning of the interface.
85 years of age is advised to operate the cataracts (both eyes) or not?
The cataract surgery is recommended at any age, when its indication is well put. Centuries are surgery of cataract, the intervention under local anesthesia (drops).
The "haze" would affect how many patients operated by PKR? What is its impact increases with the number of diopters correct?
"haze" (English "haze": mist) is a partial clouding of the cornea after PKR. Its incidence is very rare for the low to medium myopia (less than 6 diopters) (less than 0.1% of cases). On the other hand, from 6 diopters, its impact increases; It seems that the haze is also more frequent in case of cornea fine (for the same degree of correction), or when the laser ablation is irregular. Increased exposure to the Sun (especially without filtering lenses UV) to the immediate course of the intervention is also a classic risk factor. The symptoms of the haze associate impression of sailing and myopia regression (the haze is of a "on healing" to simplify, and comes so a partial return of myopia). Some haze disappear spontaneously at the time, while others may be subject to a revision surgery (re - PKR). Some preventative treatments like the local application of Mitomycin can reduce the occurrence and significance of the haze. Ultimately, for any less than 6 d myopia, the haze isn't priori to fear with a well carried out technique, and a laser new and well maintained.
Corneal topography takes how long? Should I rest my eyes upon?
Corneal topography is a non-invasive examination: it lasts a minute or two and is absolutely painless (no eye contact). Sometimes light rods used for review are somewhat dazzling for the patient.
Hello my daughter did operate by PKR May 21, 2012 can she resume activities after 5 days normal? gardening view TV computer?
After PKR, the surgeon put a "band-aid" lens that is removed after 5 days. At this stage, the vision is not yet stabilized, but it is quite possible to watch TV or leisure activities. The ports of sunglasses filtering is advisable for activities extended into outside environment (ex: gardening).
cataracts-what return l; operation after?
Cataract which is surgery is said to be primary: the lens removal and replacement with an implant (we keep however the capsule of the lens to place the implant). Cataracts which can then develop is said to be secondary: it is related to a gradual clouding of the capsule: Yag laser capsulotomy is treatment.
Hello I would like to know two things: 1. is a slight hyperopia after the operation to correct the nearsightedness (LASEK technique) is common in most patients? Will it disappear after a few months? I was operated one and a half months ago. 2. When can I make eye makeup after the LASEK on a daily basis? Can makeup products/makeup remover cause long-term damage to the eyes operated? Thank you in advance for your reply.
A slight farsightedness is usual after LASEK (generally surface techniques), she usually regresses in some weeks: to the 3 month period, you will be able to refocus. For makeup, no restrictions are set one and a half months after refractive surgery.
Hello, I heard that the benefits of a myopia laser surgery decreased during pregnancy. What is? Is it possible to consider a pregnancy in the months following surgery by keeping all of the received profit? Thank you
The effect of pregnancy of myopia is not sufficiently consistent or pronounced to postpone surgery until after the desired pregnancies.
Is that after an intervention to the PKR there is a work stoppage for 3 to 4 days that follow.
Refractive surgery (PKR or LASIK) is not covered by social security (Act no agreement), it is not possible to prescribe a work stoppage in the course of it.
Hello, young mother of a 6 month old baby and wanting more children in the future, can I consider to operate between two pregnancies or even pregnancies have impact on myopia? Precision: I'm 29,-4.5 to each eye, stable myopia for 3 years. Thank you in advance.
It is quite possible to do the operation of nearsightedness between pregnancies. Influence of pregnancy on myopia is weak and inconsistent, especially for low and medium myopia.
Hello, my 43 year old son has a strong myopia (-15) can have surgery to improve his view - if yes, how: by receiving an implant or laser thank you for your answer
Myopia-15 d is not correctable in part by laser (LASIK) surgery. By implant surgery, however, is able to fix this high myopia.
I suffer every year, more or less strongly, of chronic allergic conjunctivitis. Can the Femto-LASIK operation be contraindicated if it is in an allergic period? (strong eye irritation) I sometimes rub my eyes very vigorously because of my allergy. Should this be avoided as a result of the operation or outright definitively? (more than a year later, for example). Thank you. Kind regards.
It is actually not recommended the femto LASIK in allergic period with eye irritation. Just after the intervention, do not vigorously rubbing your eyes, otherwise move the flap of LASIK. Generally speaking, rubbing the eyes, regardless of eye surgery is not recommended.
D + 15 after lazik femtosecond for treatment of slight astigmatism in one eye (editing after 3 years). I have a split, often blurred vision from afar, and a light veil. what might be the causes, there it urgent to see my surgeon again?
The possible causes of the persistence of astigmatism, a dry eye, a slight inflammation of the interface, or the folds of the cover. Review with your surgeon will advise you.
Hello, after a bacterial infection (and ulcer of the cornea), still me have a little scar. Is it possible still to benefit from a refractive chirurge? And what would be the best method? Thank you
Surgery by laser is possible: for the choice of technique, everything depends on the size (surface and depth) of the scar. If it is significant, a surgery by laser surface (PKR) is preferable. If the corneal scar is minimal, a LASIK is an option.
What is the hair coloring is permitted 3 months after lasek? What is the diving and swimming in the sea is allowed 3 months after lasek?
These activities are quite allowed after 3 months, or even in a month after LASEK (laser surface) or LASIK
How long after surgery of cataract (without correction of myopia) can you wear permeable rigid lenses again with oxygen? Thank you
It seems better to wait ten days to minimize the risk of infection and discomfort for contact lenses.
I have currently due keratitis seems t he port too extended contact lens I'm treated in a week by vismed liposic how can we expect a return to normal of my cornea,? I'm nearsighted moderate astigmatism and presbyopia debutante timescale then consider next to this keratitis refractive surgery this keratitis is a contraindication has surgery refractive thank you in advance for your clarification
The term "keratitis" is relatively specific to many conditions that may result in superficial damage to the cornea. In your case, the treatment consists of a moisture and lubrication of the ocular surface. Refractive eye surgery is possible once the ocular surface is perfectly healed. In your case, it is important to detect a possible dry eye that could worsen after a LASIK and require special measures.
Hello, I'm myopic - 2. I have the choice between surgery Lasik and PkR. I think I'll choose Lasik for questions of comfort and recovery of quick view, but I would like to know if the flap recicatrise permanently after the operation? Because I've heard that some had lost their cover... is this true? Thank you.
The healing of the edges of the flap is fast in LASIK (24 to 48 hours). The secondary displacement of the cover (its loss is not possible because a hinge is preserved) is rare. It can occur in the first hours after surgery if the patient inadvertently rubs one eye. It is then necessary to reposition the flap to avoid induction of folds of the cover. The intervention distance, rare cases of displacement of the cover have been reported, due to severe eye trauma (ex: air bag, metal objects, etc.). However, the surgical resoulevement of a flap of LASIK is possible several years after the initial response (to correct a residual myopia, for example). Cover interface only has a weak grip, maintaining the flap instead provided by the healing of its circular edge.
I'm 41 and I plan to do surgery lasik for my hypermetropia + 5 for 2 eyes: since the age of 17 I see called floaters and I also see halos around lights: is that there will be a risk to do the LASIK surgery?
LASIK can correct hyperopia, and this is all the more interesting you'll be far-sighted in a few years: However, the correction of hyperopia priori helps you see better from a distance, but also closely. Floaters are opacities of the vitreous and have no link with the cornea (which is the part interested in LASIK surgery). You'll also see floaters after surgery, LASIK does not increase the rate however. However, LASIK for hyperopia strong can induce an exacerbation of the perception of luminous halos at night.
Hello, I'm 34, operated in the excimer laser ago 2 months for the left eye and 3 months for the right eye. (the 2 had a small myopia stabilized to 1 year at-0.75). Ago 12/10 for 2 but since my last operated eye decreased c is blurred nearly as far, so I don't feel comfortable on the computer for example. This variation is normal, this will it work out? Thank you
Please check the refraction of the eye, in order to remove a residual problem of refraction as the appearance of an astigmatism which can be induced by secondary scar phenomena. Also to look for a dry syndrome which may induce a decline in vision. Finally, the possibility of a "haze" ("MIST" in french, caused by inflammation with appearance of a light veil over the cornea) is not to be excluded, but the low degree of myopia that you present is not in favour of this hypothesis (the haze develops for correction of high myopia in laser surface).
Hello, I would like to know if it is normal to have trouble reading the small print after Lasik (presbiytie and astigmatism) operation carried out a few days before. Does take some time for improvement of the close-up? Alternatively, consider a correction by laser? Thank you!
Correction of astigmatism may require a few days to be precise: combined with presbyopia surgery, should certainly be considered adequate postoperative time. An editing may be considered after several weeks if the Visual results were disappointing.
I was operated cataract surgery two years ago; I wish multifocal implants, to avoid wearing glasses, distance vision; is it possible to redo the operation?
It is theoretically possible to change artificial cristalllin for cataract implants; However, two years after the initial surgery, the risks associated with an explantation are high. Indeed, the implant certainly adheres to the capsular bag, and its removal might require maneuvers endoculaires that could damage this bag (capsule), as well as fragile structures like the corneal endothelium. If you want to correct your near vision, other options are possible: LASIK (monovision), or an intra-corneal implant of type KAMRA on the eye not dominant. These surgeries are corneal and do not run any risk to the internal structures of the eye.
After the intervention pkr should we be blindfolded and wear sunglasses? How long should we wait to be exposed to the light? How long to find Visual acuity?
After the PKR operation it is not indicated blindfold, but wear solar tinted glasses. Exposure to sunlight must be made with caution (the port of tinted sunglasses is strongly recommended during the first postoperative month). Visual acuity after PKR was gradually in some days, most patients have a binocular Visual acuity (both eyes at the same time) between 8/10 and 10/10 a week after the surgery.
Hello, I - 10.5 D of myopia in both eyes. The laser is completely excluded and if so, what are the reasons? Even if after the operation, I'm not perfectly corrected, it's better than - 10.5 D right? I have misgivings about intra-oculaires implants, are they really safe? Thank you! :)
The answer of your question (I am operable with a high myopia of-10.5 D?) depends on the thickness and the regularity of your corneas. Only the LASIK technique is able to correct myopia of this importance. It is important that your corneas are thick at least equal to the average (530 microns in the Center) or even above average. In addition, corneas must be free of anomalies that can be mentioned the presence of a beginner infra clinical Keratoconus, or of Keratoconus frustrated which could be "opinion" by the completion of the surgery. If you meet these conditions (and present no other contraindications to the realization of a LASIK), then your nearsightedness can be corrected. As you suggest, the presence of a small under correction may not be a problem, because you can still enjoy much better glasses/lenses today independence ' today. Regarding the placement of implants intra ocular, this type of surgery is more invasive than surgery laser. Medium / long term, some side effects reported (corneal cataract/glaucoma/problems / changes in the shape of the pupil) make it difficult to offer patients to less than 40 years. The placement of these implants in all cases requires a scrupulous follow-up, with 2 visits per year with your ophthalmologist for routine screening of potential complications.
A strong myopia (about-9) and amblyopia thus causing a vision (with correction) of 6/10 and 4/10 is it operable safely? Would that allow you to recover 10/10 to both eyes? In addition, there is the possibility of performing surgery under general anesthesia in case too much stress on the patient?
It is not always possible to correct myopia of - 9 d with LASIK (except if the cornea is particularly thick). Amblyopia is a sensory issue however, and optics. Even if a LASIK is possible, or that you're surgery with implants, Visual acuity is unable to go back to 10/10 due to amblyopia. Vision after corneal surgery or implant is however better than glasses (magnification of the retinal image), and a gain of one to two tenths is possible.
When we got a keratitis with can be ocular herpes it is best lasik or pkr?
It is difficult to answer this question without a review of your cornea. If you did that a surge of keratitis, it was superficial and has not led to the cornea, the PKR or LASIK opacifications are possible, the choice to be made according to the results of the pre-surgery (thickness of the cornea, myopia, etc.). If keratitis caused a superficial clouding of the cornea, then the PKR might be better, because in correcting myopia on the surface, one would hope a reduction/disappearance of opacification (the laser removes corneal tissue to correct nearsightedness). In addition, the presence of a significant opacity could hinder the realization of the cover while the realization of femtosecond laser LASIK.
Hello! I am now 22 years old and have been operated at the age of 19 years by femtosecond laser in Lyon, with a strong myopia (-11 to one eye and-9 to the other if I remember correctly.) Regarding the practice of combat sports, is the risk diminished compared to a traditional surgery? can one for example practiced judo or boxing (with helmet glove and blow not supported) with a reasonable risk or does this remain against indicated?
The risks associated with the sport of combat with strong short-sighted are related to the retina (risk of delamination). Even if you got rid of myopia through your eyes by femtosecond LASIK, the retinal risk is unchanged. It is related to repeated mechanical shocks, which are a risk factor for the retinal detachment. Concerning the risk of moving the flap of LASIK, these are weak and not against indicate not the combat sport whose rules exclude generally fingers directly in the eyes, etc.
Hello, I am 27 years old being military, I have of getting surgery in 2008,-3,25 of myopia by excimer laser, today I have a nickel view 10/10 for each eye. Can I again wear lenses color fantasy? Y'a t - it a risk for my eyes? What do you recommend? Thank you!
It is not against indicated in principle to defer lenses color in a timely manner, respecting scrupulously the hygiene rules (hands, product maintenance,...). It is strongly recommended to sleep with these lenses in all cases.
Hi I am 28 years old and I suffer from high myopia - 22 D 2 eyes, I do the same femtolasik to lessen the degree of myopia?
A myopia of 22 D is not accessible to the femto LASIK. This operation might reduce your myopia, but residual myopia (close to-10 D in the best case), would be too strong for the benefit of this myopia surgery is interesting for you. It is preferable to continue wearing contact lenses.
Hello, can you you have surgery if suffering from myopia, farsightedness and astigmatie? Get you you his view at 100%?
Yes, it is the field of refractive surgery which includes all of the techniques of the eye operation able to provide independence to the glasses and lenses, whether for nearsightedness, astigmatism and farsightedness to interested patients (as well as presbyopia). Good candidates are good results, and it is very important to perform a preoperative workup to eliminate counter indications. When the operation is possible and that the correct technique is chosen (LASIK, PKR, etc.) so we get a vision to "100%".
Hello, can ' you have surgery if suffering from myopia, farsightedness and astigmatie? Get you you his view at 100%?
Refractive surgery can correct these optical defects; However, one cannot be both nearsighted and farsighted on the same eye (these defects are opposed). Astigmatism can be associated with myopia or hyperopia; It is corrected at the same time as nearsightedness or farsightedness. You will find information about surgery for nearsightedness, farsightedness and astigmatism on this site. The Visual recovery can be 100%, in other words the majority of patients in good conditions, after excluding the bad candidatas and contraindications, recover a total independence to the glasses and lenses. However, some minor side effects may accompany the postoperative refractive surgery.
What is the richness of your technical platform allows precise identification of a secondary effect that a "classic" ophthalmologist cannot detect?
Some Visual complaints such as halos, double vision, are sometimes difficult to objectify. Explorations of type aberrometrique and topographic use often highlight the optical anomalies such as the aberrations of high degree, or the light diffusion.
Is the richness of your technical platform allows precise identification of a secondary effect caused by surgery for nearsightedness?
It is difficult to answer this question without knowing the type of side effect caused. The OPD is a study technique which allows in most cases to authenticate the optical origin of a symptom Visual post surgery. Corneal topography allows to connect these disorders to the cornea (or to exclude a corneal origin, which can be useful when the operation of myopia is not laser but to use an implant). There are other investigations, whose principles and topics of studies are varied. The technical platform of the Rothschild Foundation has way to cover all the fields of investigations related to myopia surgery, even in the most comprehensive way possible all of the eye operations.
What is the time of recovery of vision close (reading, computer) after a PKR? What that can delay this recovery when the epithelium is restored to 100%? Thank you
After PKR, even when the epithelium is restored, there is a phase of "remodeling", or the cornea tends to be re - thicken a bit (and so erase a bit of effect induced by laser). As a result, we anticipate this decline by a slight over-correction that short-sighted, can make it a little more difficult to vision closely in the first days/weeks after the initial operation.
10 years after LASIK surgery, my myopia is back and I am reporter of glasses... I hesitate between the port of special lenses or a new eye operation (possible according to the surgeon that I saw). What do you recommend because I am scared of getting surgery?
It is quite possible to envisage a reintervention after LASIK. This is to resoulever the cover cut initially, which is possible in almost 100% of cases in my same experience 10 years after cutting (the "older" flap that I had to resoulever was 14). Please make sure that the underlying cornea (once the flap is raised) is thick enough (the so-called "rear"residual wall thickness), and we can appreciate this thickness in conducting a review OCT of the cornea. A video of this technique of resoulevement is available here: http://youtu.be/ubGOviDkKLw
On the other hand, the techniques of recutting a flap on an old flap are more "uncertain" in terms of Visual result, because they expose to certain complications (micro folds, irregularity of the interface, etc.).
Bonjour.Jai 26 years old and I suffer a strong bad vision-14 for both eyes can I do thank lazik surgery :)
Lasik allows to operate the myopia up to 8-10 diopters: in the past, the cornea may be too thin. It is preferable to opt for a correction in contact lenses in your case.
Hello I'm 55, myopic - 8 G - 6 d with a slight astigmatism, and presbyopia + 2.25. thick corneas; PIO higher treated with Xalatan, no damaged optic nerve, Visual field intact. Can I be surgery to correct nearsightedness and astigmatism? What is the recommended technique
If your corneas are thick and have your Crystal clear, LASIK seems a priori technology to offer first. If you show a beginning of cataract, it could however be a good idea to propose a replacement surgery the lenses with a suitable power implant (intended to correct your myopia on one side or both, or well under correct one eye slightly so that you can read without glasses on this side: monovision technique). The high presence of an IOP (intra ocular pressure) is not necessarily synonymous with glaucoma in your case, and more so your corneas are thick: indeed, the measurement of eye pressure can be artificially increased by a higher than normal corneal thickness. As a result, it might be interesting to perform a measurement by double unfortunately (Ocular Response Analyzer) to rectify the measure of pressure to the biomechanical properties of your corneas.
J had surgery in 2002 by lasik with d cut a cover but I don't know if this was done mechanically by the surgeon or femtosecond laser. Having at the time - 7 and - 7.50 D my myopia has always been slight residual which didn't bother me for driving or sport... but for 1 year j I-1,25 D 2-eyed, I'm embarrassed to drive at night, sport... and strong visual fatigue. I have reconsulte my surgeon that offers me a pkr telling me what she do editing to lasik. Impossible to reopen the lasik.je don't know if it is because he does not control this technique.car I see that d other surgeons do? The pkr is effective on a lasik? I would like to make a retouche.merci in advance for your professional reply.
LASIK and recurrence of myopia, it is almost always possible technically to re the cut initially Hood (even several years later, and that LASIK has been made to the microkeratome or laser femtosecond). We need however to ensure that the thickness of residual cornea (under the hood), so-called "posterior"residual wall thickness is sufficient to correct your myopia. We measure this thickness with a test called OCT. If the residual wall is too late (less than 250 microns), a PKR can be performed after a LASIK, but she does run the risk of a "haze" in such circumstances (history of LASIK for high myopia). In conclusion, if the thickness of the cornea under the flap is sufficient, it is rather appropriate to resoulever the flap to treat your myopia residual to a PKR.
Thank you for your response rapide.mais j have more precision: indeed, in 2002 when my myopia residual I did an oct post-op that indicated about 400 microns thickness of residual cornea. Same result if priori better resoulever the cover c does this present it risk? side effects? and if j opts for the pkr haze v at t he decrease or disappear or stay for life? Thanks again for your clarification and your site!
If your cornea has a near 400 microns thickness, then measure the thickness of the flap at the time and subtract it to estimate the thickness of the "residual rear wall". In general, it is estimated that the thick of it should not be less than 250 microns. To measure the hood, a review OCT.
Hello I am 17 years old and I have the myopia - 2.75 D in both eyes. At what age do you recommend to Lasik? That myopia may increase post-surgery? thank you
The minimum legal age to perform refractive surgery is 18 years. However, the recommended age is one for which the myopia is stable: this may still take a few years in your case. We can attest to the stability of the myopia when correcting glasses no longer changes. Finally, it should also ensure that your eyes are compatible with LASIK. If irregular or thin cornea, the PKR may be more appropriate for a close myopia of 3 D.
Hello, it takes how long to assess the result of an operation of the myopia/astimatisme by PKR, and be sure that the vision will not move? It seems to me reading that he had to wait 1 year before any editing. Is this correct? Thanks in advance for your answer.
The period of stabilization of the effect of the surgery by PKR depends on type and importance of the correction issued. In general, it is estimated that stabilization occurs between 3 and 6 months after surgery for the correction of myopia: more initial myopia is strong, and over the period of stabilization may be extended. A year seems in any case sufficient in all cases. For your information, the reappearance of a slight myopia long after surgery is not necessarily related to the effect of this loss but a scalable recovery of nearsightedness (high myopia, greater than 7 D, tend to evolve longer than weaker myopia: that said, the PKR concerns especially the myopia less than or equal to 6 D).
As a result of Lasik Surgery is it normal to feel discomfort like a bad door lens, a week after? Can you feel this kind of gene occasionally again in the months and years following the intervention?
This type of feeling (foreign body) is quite common in the hours and days following LASIK. It should gradually disappear. His resurgence is more related to a possible dry eye.
I'm 48, I had surgery 1 years ago for the astigmatime that made me the blurred vision from afar. I also had a beginning of presbyopia. Now I can see very far but nothing more closely and I have also problems to see up to 3 feet (1 meter) away from me so I have to wear glasses almost always and is to avoid this I had surgery. Can I wear contact lenses to correct my reading vision as well as 3 feet from me? What is the solution you offer me?
Your presbyopia has probably increased since last year. Having become "Emmetropic" (good vision of far either corrected), your presbyopia now impedes your vision closely (presbyopia starts around 44 years and progresses up to about sixty years). To remedy this presbyopia, there are two main solutions: 1) (toggle) monovision, which would be to conduct a retouching on non-executive eye to restore vision closely (but in this case, the vision is by far less accurate). It is possible to test this result through a contact lens. (2) the placement of an implant Kamra (see dedicated page on the site) which is made in the cornea (a small tunnel is created with a femtosecond laser, and the implant is simply slipped. The advantage of this technique is that it affects less the vision by far as monovision. Eye surgery (also non-executive eye) etrouve a greater depth of field. The kamra just get approval from health authorities in the Canada.
Can a post-LASIK dry eye cause a moderate decrease in Visual acuity (sensation of blurring or veil) and how to treat it (artificial tears +/-vitamin A ointment +/-local corticosteroids)?
Dry eye is a common complication of LASIK. It can actually cause a reduction in Visual acuity (bad quality of the tear film). The treatment combines artificial tears, wetting agents, or even tear gels. The vitamin A ointment is prescribed drought severe, accompanied by superficial keratitis (corneal epithelium suffering). Corticosteroids have an indirect effect, because the drought there is an inflammatory component. Tear caps installation allows to increase the contact time of tears with the cornea and can be advocated in the forms of severe and prolonged drought. These caps tend to disappear naturally after a few months, if they have not been removed beforehand.
Hello, there is often mention of dry eye after LASIK surgery. What is this dryness becomes permanent or fades t - it day after day? Thank you.
It is difficult to generalize the evolution of drought post LASIK eye: some patients show that a minimum degree of dryness, others are bothered for several months. Finally, some patients report some degree of residual drought persisted, even many years after LASIK. However, it tends to fade over time in most patients.
A-is there a contraindication to operate a low myopia + low astigmatism (OD and OG-1, 25 (0.50)) LASIK when there is a moderate from the convergence of an eye disorder? Should re-educate in orthoptics before or after? Thank you.
A priori the LASIK operation is possible and does not expose to a worsening of the disorder of convergence. Orthoptic therapy can be done after the intervention.
Is there really less risk of corneal ectasia and side effects (halos, night vision, dryness, etc) with the femtosecond (100% laser) with a microkeratome or that it depends of the degree of myopia and astigmatism, and/or the experience of the surgeon.? Some advanced CHU lack of femtosecond while all forums recommend. What do you think? Thanks in advance
Femtosecond technology represents a costly (about 500 000 euros off maintenance for the platform), which explains that some centres of rush, can be equipped with (refractive surgery is unfortunately rarely seen as a priority activity in most of the CHU!). The absence of this technology also allows some centres (public or private) to offer low-cost"rates, because in addition to the cost of the equipment, there is an additional cost for each procedure of femto - LASIK (a few hundred euros). Today, beyond the marketing, the benefits of this technology arguments are true. In the case of desertion of suction during the creation of the cover (uncoupling of the instrument with the eye, which happens sometimes, especially when the cornea is particularly flat), the consequences of a cutting blade (microkeratome) are unpredictable: partially cut or perforated, cover etc. With femtosecond technology, it is possible to simply and immediately resume the surgery and complete the LASIK procedure without consequences. Dimensions (diameter, position of the hinge) LASIK covers are customizable with the femtosecond laser; This is not possible with the microkeratomes. In addition, the centering of the LASIK flap on the pupil is an important parameter to ensure a good balance of corrective treatment then issued by the (photoablation) excimer laser. With the femtosecond laser, you can see the trail of cutting of the cover in advance, and reposition it on the pupil if announced shift (this happens for wards slightly biased towards the center of the cornea, and on some eyes for which the installation of the suction ring is done systematically shifted way towards the cornea). All of these adjustments allow for covers of size appropriate and perfectly centered on the pupil, which reduces the risk of shift, or effective optical area reduced, and therefore the risk of halos. Finally, the control of the thickness of the flap is much more accurate than with the microkeratomes. In the past, these cut sometimes much more "thick" than expected, with a risk of excessive thinning of the cornea (and therefore risk of corneal ectasia). To compensate for this risk, microkeratome manufacturers have designed more specific cutting heads, but which sometimes cut... too finely. Finally, it seems not to be much difference in terms of dryness induced between laser cutting and cutting blade. However, the benefits of the femtosecond laser cutting (increased security, better balance, adequate dimensions) are objectively enough for don't hesitate to choose this technology (100% laser LASIK) rather than the microkeratome.
I have to have surgery soon to lasik for a farsightedness from + 5.5 in both eyes... site of the surgeon who must operate on me I read that it operates to lasik that less than 3 or 4 diopters hypermetropies, yet it has not issued reserve during my pre operative consultation... What should I think?
If I tell you that we should not believe everything can be found on the websites... I'd be - well annoyed. More seriously, it is possible that this surgeon has been equipped with a newer laser platform, or that he has meanwhile had the opportunity to verify satisfactory results for operations on strong hypermetropies. However, it is true that high hyperopia correction is more difficult than that of myopia, for reasons mainly related to the profile of the correction issued on the cornea. With a farsightedness from + 5.5 D, if your cornea have consistency required, and the excimer laser is latest generation, then it is not unreasonable to propose an intervention by LASIK. There is however, the risks of side effects in night vision (halos), and scar regression with return to slight farsightedness.
I was operated on femtolasik a week ago (OD-7.5 OG-8.5 with light astigmatism): today during a control, I have myopia at zero OD but OG with-0.75 of astimagtism. can this remaining astigmatism still disappear or should I expect a retouching? my left eye is pretty tired, the surgeon tells me to wait a month; What do you think?
Induction (or non-fixed) a slight astigmatism can be obsevee after LASIK for high myopia. Various phenomena can contribute, and based on these, the persistence of astigmatism can be established or not. A transitional dry eye with slight irregularity of the ocular surface can explain this astigmatism, the effect on vision must be significantly less penalizing than that of your initial myopia of diopters-8.5!
Hello, are there any side effects following a bilateral Femto LASIK laser surgery? Visual blur, veil? Are they reversible and on average in how long? In advance thank you for your reply.
Like any surgery, femto lasik (lasik all laser) is a source of adverse reactions, mainly dry eye, and possibly nocturnal bright halos. A sensation of "fog" is usually felt in the first hours. You will find on the site of the pages devoted to these symptoms, as well as the conduct of the postoperative:
Hello, I am 40 years old, and I was operated 2 months ago by LASIK for a low myopia + astigmatism (-1.25 (-0.50)) in Monovision. I do not tolerate it (violent migraines and lack of convergence to the discourses) and it may be that the eye Director was badly chosen... Several questions arise to me: * should I make his myopia to the eye operated (I read articles in this direction) by re-raising the flap with all the risks that this entails (calculation imprecision, post-operative risks)? * is it necessary to operate the other eye to have no lag knowing that you will have to wear glasses for presbyopia? * is it absolutely necessary to address the problem of inadequate convergence (orthoptie) before any refractive surgery? Thank you.
Monovision is sometimes poorly tolerated, and it is best to test this configuration before the operation, by doing a test of correction with contact lenses. In your case, rather than re operate the corrected eye and give him back his initial myopia, it seems better to correct the second eye, and accept the idea of wearing glasses for near vision... in a few years because in 40 years, it is still possible to read comfortably without eyeglasses (presbyopia - symptoms - starts around 44 years). Once both eyes operated and "equalized" symptoms (headache, etc.) should disappear. Be aware also that if you decide to re operate the eye, after LASIK restatements are generally well tolerated and effective.
I am suffering from myopia on both eyes (-3 and-2) and would like to have me operate by LASIK (with a femtosecond laser cut). Also, I was often told of shards or halos, especially for night vision and I would like to know what are the risks of having these kinds of problems and if they disappear over time. I would also like to know if the vision after operation is comparable to the vision (day/night) with glasses/lenses or if there are any differences (e.g. halos, splinters, etc.). Thank you so much. Kind regards. Steven
The correction of myopia in the order of 3 diopters does not expose a high-risk bright halos and night vision problems. Daytime vision and night vision should be similar, at least a few weeks. The risk of halos relates instead to the high myopia (greater than 6 to 8 diopters).
Hello I have 41 and I suffer of a squint very important and I would like to have the surgery by laser, is this possible?
(Corneal photoablation) laser surgery to correct an optical defect of the eye. It is not intended to correct strabismus, that it not worse either. So, it is possible that you can benefit from laser surgery.
Hello doctor, practicing MIME, which requires various facial expressions, with ample movements and promonced eyes in every way for good times, I wanted to know if this have consequences on eyes that have undergone a LASIK for myopia, and therefore have a thinner cornea after LASIK (I think I remember that I still had 285 to 300 microns) as well as the intensive gym; the efforts requested do not provoke an internal eye pressure, which would have the effect of sounding on the thinner cornea? thanks to you
LASIK is quite compatible with the practice of sports such as gymnastics or activity such as mime. Only repeated eye rubbing must be prohibited after LASIK.
In pkr, j until ' what correction can treat a myopia? And how much thickness of ablation allows a pkr?
PKR (surface laser) allows to treat myopia whose magnitude can reach 6 diopters. This corresponds to a depth of ablation near of 100 microns (the depth of ablation also depends on the diameter of the optical zone). We can treat higher myopia, but increased the risk of haze (corneal inflammation) and scar regression (return of myopia linked to 'excessive' healing).
Hello, during an operation of presbyopia, what are the criteria that will opt for monovision (sometimes poorly tolerated) technology instead of the kamra who seems to have only advantages (durability, reversibility)? Thank you.
As you mention in your question, monovision is sometimes poorly tolerated. This is the fact that in some patients, the preservation of a binocular vision by far seems necessary to not feel any discomfort or an imbalance. The kamra preserves binocular vision (depth perception), and is actually reversible. However, some patients have a positive experience with monovision, (often short-sighted), who were able to test it by wearing lenses of contact with slot on the side of the non-dominant eye correction. When the monovision is effective, it has the advantage of being a simple implementation technique, and does not require the installation of an intra corneal inlay.
Hello. I'm 36 years old. I have been operated by myopia 11 years ago in Dec 2001 with a retouching in March 2002 (opening of the flap + laser). Having a normal myopia at the time in addition to being astygmate (-6.5/-7 dioptres) I quickly recovered a very good visual acuity. But since 2-3years (especially this year) my eyesight has fallen so much that I have to postpone glasses of sight. Maybe this is my pregnancy that spawned this sharp drop (in 2008) or the accumulation of hours spent on the computer?! (work). In short, my question is whether I could postpone contact lenses or if surgery is necessary in the next few years because I am really afraid to go back to the starting point. Handing out glasses is a bit of a "handicap" for me both at the practical level and aesthetic... Thank you for your reply..
High myopia (high myopia is set in a relatively consensual manner as a myopia greater than-6 D) are sometimes scalable: reached high myopia eye is an eye which the excessive length explains myopia. The elongation of the eye can be extended, despite a sense of stabilization around 30. Pregnancy is conventionally invoked as source of scalable recovery of myopia, but the mechanisms involved are unclear in this context... The work on display is a priori for nothing in return of myopia. In practice, it is possible to wear lenses, adapting their radius of curvature to the profile of your operated corneas. Surgery is possible if the thickness of your corneas permits (it comes in particular to the posterior residual wall thickness, that is, the thickness of the cornea under the flap of LASIK). In this case, it raises the old cover (this is possible even 10 years after the initial surgery) and we deliver a complementary photoablation under the flap that is then repositioned. A review by OCT allows to measure the thickness of the layers of the cornea (cover vs posterior residual wall).
I have 70 years and cataracts. With a strong astigmatism (cylinder 4 D) and a high myopia of - 18 d, what are the chances of not having to wear glasses (except for read) after cataract surgery? Can we reduce the astigmatism with o-rings implants entirely and no longer need to wear glasses?
Cataract surgery to correct the myopia as strong as yours, as well as astigmatism, in this case using a toric implant. Biometrics can be calculated so that your eye is corrected for the vision by far. That said, there is a degree of inaccuracy in any biometric calculation, and are generally advised to strong short-sighted aim to remain slightly nearsighted (ex:-2.50D) after cataract surgery. Despite this residual myopia, the improvement is strong and felt, and reading and execution of common Visual tasks closely are possible without glasses.
I got LASIK operated there are a little more than 3 weeks and I have a blood spot on the color of the eye which has a somewhat dimmed but not yet fully this for ca I have a slight white veil in front of the eye and when will I see normally again?
The "red spot" on the white of the eye after LASIK is always temporary (it comes from a small hemorrhage under conjunctival), she disappears in addition to 3 weeks sometimes. However, it has no effect on vision and cannot explain the occurrence of a Visual sail.
At the age of 37, operated in the femtolasik 3 months ago of a low myopia and astigmatism (OD-1, 25(-0,50) 20 ° and OG - 1, 140 ° 25(-0,50)), I see still blurry closely for the right eye and my vision on the computer or reading is tiring. The refractive values at 3 months show for this eye + 0, 50 (-0, 50) 20 °. How can we qualify this refractive anomaly (hypermetropique oblique astigmatism)? What is a sur-correction, even minimal? Should you consider a touch up if it bothers me, is more difficult than for a sous-correction, and what are the risks? Otherwise, extra for near vision glasses are less risky? Thank you.
The refraction of the eye is a lightweight direct hypermetropique astigmatism. It may explain your near vision gene. A touch-up is not to be excluded if the discomfort persists; This gesture is quite secure and is surgically resoulever the flap of LASIK and deliver a further correction. He must be sure of the stability of your vision, eliminate any problem of drought can change your vision; wait another few weeks for judging.
I am currently under azopt for high eye tension, can I benefit from a laser or lazic for a correction of sight?
The presence of an ocular hypertonia is not a absolute contraindication to refractive surgery; requires however a good decline, stability of eye pressure which must be well controlled under treatment, and have made an assessment (Visual field, imaging of the optic nerve). After surgery by LASIK or PKR, the eye pressure is measured lower than before the procedure. Indeed, the thickness of the cornea has an impact on the measurement of intraocular pressure. This pressure reduction is not in itself a sign of an "improvement" of the situation, but what is called an "artifact" (measurement error). That's why that other indicators of monitoring hypertension or glaucoma should be used after surgery. Some instruments of measure as the Ocular Response Analyzer (ORA) allow obtaining more reliable measures after refractive surgery than conventional techniques.
I myself am 13/11/12 in the left eye by PKR for myopia surgery to-1.75. I was also diagnosed a slight astigmatism, we never talked to me. A month, I'm always short-sighted of 0.50, but above all I am now agstigmate. The surgeon tells me that it is related to healing. Off I don't see anyone involved in this situation. Is this possible? This will you it subside? Is it not an astigmatism induced by the operation? In this case will you it really subside? Should it operate? Where then is the veil of healing? How do I know and get the right answers? I'm being told to be patient while waiting on computer I see nothing!
It seems that you are slightly under corrected, but induction of an astigmatism during the healing process can reduce vision. During the pre-operative tests, measured refraction in very specific, often resulting in the "discovery" of little astigmatismes, it makes sense to fix in addition to nearsightedness. The induction of astigmatism after the operation is also possible, it may be transient; otherwise (persistence after 2 or 3 months), it is possible to consider its correction, if it truly affects vision. One month, it is still a little too early to judge.
To combat the dry eye following a femtolasik, after what post-operative period (15 days, 1 month?) and how much daily (evening or more often) can be used without the risk of stuck flap or cause an excess of healing ointment vitamin A? Thank you.
Dry eye is one of the more common side effects of LASIK (the more common?). The manifestations of this drought combines a feeling of dry eye, and sometimes a transient visual loss. The prescription of artificial tears may be indicated even several months after LASIK. The ointment is rather reserved for severe and complicated keratitis droughts: However, no risk of damaging the flap after 48 h; the grip of it is sufficient. Similarly, no risk of "excesses of healing!
I have a strong myopia (-6,75 and-6,25) and a low astigmatism. About a year ago I made a pretty severe dry keratitis, which is is healed after a few months, but since the keratitis my eyes remained dry enough, I put the drops several times a day, and I can't stand contacts for more than a few hours at a time. Is my dry eye is a contraindication for LASIK? What of the KPR? Is it possible to have the surgery and ask caps to address dry eye? I am 21 years old. Thank you.
Dry eye in its current forms is not a absolute contraindication for LASIK; Instead, many patients to a form of dry eyes want to refractive surgery because they tolerate bad contact lenses. However, the induction of a drought or his accent are common after LASIK, and also the PKR (the PKR seems less induced drought in practice, but this issue remains controversial: the drought induced by the PKR seems, however, less intense and less prolonged in my experience). Of course, do not operate dry keratitis with eyes, this might also complicate it make difficult the achievement of a flap of LASIK with femtosecond laser. If the surface of the eye is healthy and free of keratitis (you can check this by inspecting the ocular surface after any instillation of dye) a LASIK can be offered, and the installation of tear caps performed at the same time or secondarily. Some studies suggest that intensive hydration of eyes before the surgery ("cure" of artificial tears) could reduce the intensity of dry eye in post operative. The PKR is a potentially interesting option (although its effect on drought can also be deleterious, this point is controversial), but to the degree of myopia that you present, it is feared a small under correction with this technique. Finally, there are several forms of dry eye; When it is linked to excessive evaporation of tears (bad quality of the tear film), she even in connection with blepharitis (ex: rosacea, dysfunction meibomien), the treatment of blepharitis advent LASIK can make sense, improving the quality of tears providing simplified postoperative.
I had surgery for my hyperopia / astigmatism five days ago, my near vision is very good, on the other hand, by far, it decreases every day (good the next day, and more and more blurred). Is this normal? I expect that my sight will improve day by day, not the contrary... When will I see again normally?
Visual fluctuations after surgery to the hyperopia are usual over the first few days. They relate to parameters such as dry eye, transitional scar remodelling, reflex accommodatifs "efforts", etc. It takes several weeks to judge; in principle, the vision by far should gradually improve. Be patient!
Following an operation by PKR, is there a time limit before you travel by plane?
The minimum time limit seems that of the healing of the epithelium or 3 to 5 days in practice. It may be useful to rehydrate the eyes with saline during the trip.
I'm 16, my left eye myopia is stable for 6 or 7 years, will you it reevoluer?
Even if the stability of myopia for 6 or 7 years represents an element for stabilisation, can't however be completely certain that it will not worsen in the future: the growth of the eyeball stops after a variable delay, but if your myopia is "low" (less than 3 diopters), stabilization is more than likely. On the other hand, if your myopia is more pronounced, is unfortunately not impossible that a future growth is to fear. In particular, the strong myopia (greater than 6 or 7 diopters) tend to worsen over time. These myopias differ probably the low myopia of share their mechanism. Low myopia are associated with a mismatch between the length of the eye and the optical power of the refractive elements (horny and crystalline). In other words the length of the eye (axial length) is a little more important that wished for a clear vision, but it is not "per se" (we could even consider that at some low myopia, this isn't the length of the eye which is excessive, but the power of the cornea). These day are called "refractive".
Conversely, strong myopia are characterised by a truly excessive axial length; These eyes have a more stretchy (sclera) wall, which tends to make them lengthen over time. These myopia are called "axiles".
The legal minimum age for myopia surgery is 18 years: However, some myopia are not stabilized at this age. In conclusion, to consider that myopia is stable, it is necessary to appreciate several elements such as age of course, but also the degree and type of myopia.
Learn more at: https://www.gatinel.com/recherche-formation/myopie-definition-mecanismes-epidemiologie-facteurs-de-risques/classification-de-la-myopie/
Can we watch TV and go to the movies after an operation less than 1 week pkr?
If the vision obtained after the PKR response is satisfactory, watching movies on screen or film is not dangerous and quite possible - it is the same after a LASIK.
I have to have an operation by Pkr in 10 days. At the consultation for an OPD, I have removed my lenses than 12 hours before. Can it be consequences on different measures of the eye made by the ophthalmologist? The measures taken are they not distorted?
If your lentil are flexible, this delay is priori sufficient, on the other hand, if your lenses are rigid, review aberrometrique (or topographical) results may be affected by a withdrawal a few hours before. Rigid lenses induce a change in the epithelial surface of the cornea, and it may be several weeks after their removal to the epithelium to resume its "natural" geometry.
I have a very strong myipie-24A left eye with average cataract. I'm going to operate next month. Good review OCT but retine very thin. How can I hope to myopia waste given that wearing glasses after surgery won't be me a problem. Thanks for your reply.
Type cataract surgery can correct any degree of ametropia (high myopia in your case): biometry with adapted to the desired correction implant power calculation has to be carried out at your pre-surgical assessment.
I travel by plane before my PKR surgery; is there a deadline between my return and intervention?
You can travel by plane before the intervention of PKR (the same day as needed).
Can we and from when new lenses? My myopia was-6 and-7. Operated by PKR, I'll currently be 6/10 five weeks after the operation. My surgeon told me that with my lens corrections I was between 8 and 9/10. I'm afraid of is not enough to recover. Could I achieve the same level of correction once again?
In theory, the port of lens after an intervention is possible and can correct one under correction, or a residual astigmatism, which may explain your incomplete recovery. In practice, changed the geometry of your cornea, and the eye being can be a bit more "dry" than before the operation, and yet for some weeks, it is not advised to postpone lenses. Occasional glasses is more advised. Finally, a surgical remodeling may perhaps be discussed based on the results of Visual and corneal.
Then I go to the cinema 5 days after my operation d a cataract eye, then I watch some of my computer?
If your vision is satisfactory, cinema and Informatics (computer screen) will not run no risk to your newly operated eye of cataract.
Good evening, thank you very much for this site particularly informative. I will be operated from my myopia (-2.25 to each eye, associated only with the OD of a small astigmatie), Thursday 24 January (OD) and Thursday 14 February (OG). (PKR). I had all the information I needed from my ophthalmologist, I simply forgot to ask him the time needed to resume swimming. I presume that chlorine and the microbes in the basins are not recommended for the first time for scarring. How long does it take to wait? Thanks in advance.
Actually it is better to stop the swimming sessions for a period of about 2 or 3 weeks after surgery. Then, the recovery is possible if the initial healing is done safely, and goggles to avoid a contact with the disinfecting agents that are particularly irritating to the eye's surface. By the way, I take your question to remind that swimming with contact lenses is very discouraged, as this exposes to a particularly serious infectious risk: amoebic keratitis (amoebae are parasites that are found in the waters of pool, tap, etc.).
I was operated in 1995 of both eyes by radial keratotomy (3 dioptres myopia and 1 dioptria astgmatism about 2 eyes); Pthen on left eye still myopic and satigamatism operation PKR in 2001; Result good enough until 2005 and then left eye degardation important until end 2009 hyperopia and astigamatism: today default + 1.5 (-1.75 to 100 °). Strong imbalance with right eye him hypermetrope tendency and light astigamatism. Given the failure of the PKR is it possible today to try a retouching LASIK and what would be the possible risks and results?? Thank you in advance for your reply
The completion of a LASIK after radiaire keratotomii and PKR exposes some complications; the cutting of the flap will be especially delicate especially. A new PKR could however be proposed to reduce your astigmatism hypermetropique resiudel.
Hello, operated there are a little over a year of a farsightedness and astigmatism I now aberrations optics especially at night (ghosts, halos, images etc.). It remains a small residual hypermetropia (+ 0.50) on each eye. Is a new operation possible to correct these optical aberrations? Thank you in advance.
The correction of hyperopia may induce a rise in the rate of optical aberrations of high degree including spherical aberrations negative: these aberrations cause these Visual sensations (halos) when the pupil dilates, night vision, or in dimly lit places. An editor can be considered, but it may have a negative effect on the degree of correction and give back to the hyperopia, or instead overcorrect and induce myopia; in other words, when trying to re process to improve the Visual quality of patients to the hyperopia, it is often difficult to do not change the correction (which is satisfactory in your case, + 0.50 D to the hyperopia is not embarrassing priori). Halos often tend to be less perceived over time.
I'm 50, I'm nearsighted: OD-4, 00, OG-3, 75. And I consider a correction of my myopia. Despite my (Advanced) age, I'm still not far-sighted? If I am eligible for the operation, what is the correction risk changer? Would I be far-sighted? And is it normal to not be achieved this pathology at my age? I became blind late, at the age of 28. Can my late myopia be a negative factor for laser operation? Can my myopia still evolve? adversely? Thanks for your replies.
The late appearance of your myopia is intriguing indeed: most of the myopia are related to an elongation of the eyeball, and begin during childhood or adolescence. In your case, it faudraitt out of principle a nuclear cataract (index myopia), but this one would be accompanied symptoms (decrease of Visual acuity, sailing, etc.). Corneal myopia is also possible, but would be accompanied by an astigmatism and a Visual annoyance. This type of ailment is likely to be accompanied by a progressive myopia. Moreover, the absence of felt presbyopia can be linked to factors such as the presence of optical aberrations, and/or a small pupillle in near vision that could induce an increase in depth of field. If an operation was necessary to correct your myopia, it is possible that your near vision is "harder" without optical aid.
I'm 48, I was operated more than 20 years ago from a radiaire keratotomii for the 2 eyes with the knife diamond for myopia. I start to experience difficulties sometimes to read the small letters from Pres. could I get surgery as soon as it will be well installed despite my surgical background of presbyopia?
There are various techniques able to provide you with a better near vision: (PKR, LASIK) excimer laser corrective techniques may be considered on the basis of a possible anomaly in distance vision. Similarly, the placement of an implant KAMRA in the non-dominant eye is an interesting possibility in some cases of operated eyes of radiaire keratotomii.
I have to be operated by LASIK soon with a strong myopia-11 OG-9 OD. My cornea is quite thick 576 microns, but rather flat 41 microns. the surgeon informs me that with a flat cornea the myopia can come back? In advance, thank you for your lighting.
The thickness of your cornea is above average (540 microns) and allows to consider a total correction of your myopia. It is actually documented as "flat" corneas (less curved than the average, which is close to 43.5 D) represent a risk factor for slot correction / regression. A myopic eye with flat corneas is an eye which the axial length is bigger that an eye reached the same degree of myopia, but with more curved corneas. This look is more "distensible" and it is pobable that the slot correction observed in the course of the interventions of chiurgie refractive LASIK type is related to a further development of nearsightedness (elongation?) rather than to a specific response of the cornea with the laser correction. Incidentally, having a flat cornea mathematically means a slightly shallower than a cambered; cornea ablation This part can be with the historical trend. Whatever it is, one can "anticipate" the programming a bit stronger than that measured correction to anticipate this effect "under spell".
I'm 50 years old, I have astigmatism and presbyopia, operation at the same time the 2 eyes is it possible? which method employs t we?
Several techniques may be considered but LASIK seems a priori the technique of choice: she can correct astigmatism, and induce a monovision (one eye is corrected for distance, vision one for near vision). Monovision can be tested in contact lenses before the procedure to simulate the Visual result (some patients get used to the difference of correction between the eyes). There are also techniques "multifocal" correction in LASIK, which are particularly interesting if you are also slightly farsighted. When a beginner cataract patients with astigmatism and presbyopic, can consider the placement of implants, multifocal and o-rings.
Hello, I've been to femto lasik eye surgery second 10 days ago and I see always blurry and I supposedly micro folds on my flap and I don't see anyone facing this problem, how to improve it and how long it may come back normal?
The microphone folds of the cover occasionally occur in case of difficult technique, particularly thin cover, and actually induce a type of permanent blur visual discomfort: Unlike the blur induced by conventional optical aberrations, the blur induced by micro pleats is sometimes accentuated in the case of bright lights. Reviewing OQAS allows you to measure the effects (the microphone folds induce an increase of light broadcasting). Over time, the microplis tend to disappear. The prescription of tear gels can sometimes mitigate the effects.
What's a residual astigmatism (-0.75 D) after a PKR is likely to facilitate the vision in the age of presbyopia? The very slight visual disturbance by this astigmatism relates to activities such as driving a car at night.
Actually astigmatism allows (as certain aberrations of high degree) to increase depth of field: the criminalization in vision by far is relatively moderate, and this discomfort tends to increase in night vision. However, it is also present in day conditions.
Between the PKR and lasik, is there a technique that seems more efficient to correct astigmatism?
It depends on the degree of astigmatism. In my experience, the PKR can correct the astigmatism up to 3 D. In the past, it seems preferable to opt for LASIK if possible.
Hello, can ocular herpes be a contraindication to refractive surgery for myopia average (-5 to each eye)? Thank you
If you are referring to a former surge of herpes and having not caused injury or particular corneal sequelae, it is quite possible to consider surgery (LASER or LASIK). When ocular herpes is, but leaving no sequelae, prophylactic antiviral oral therapy may be considered.
I'm 26 years old, operated 2 months and 12 days ago for slight nearsightedness and astigmatism LASIK. Since I have not found a clear view and precise, work read closely is almost impossible, is this normal at this stage of post operative? What does he have? It seems that I've been on fixed and I became farsighted (0.75 + and + 0, 50) is that it's linked? What do I do? I have a dry eye and important optical aberrations: halos, sensitivities to the lights that I see neon, iris very developed around light sources. Is that things can evolve or what at the postoperative stage, nothing will move? What do I do?
You seem to present at least two problems: (1) the sur-correction of the myopia surgery causes a farsightedness which causes eyestrain most marked in near vision itself. The optical aberrations of high degree rise can be linked to the intervention itself, and/or the conjunction to a dry eye: This explains the nocturnal halos. However, the perception of colored lights, iridescent, in "Rainbow" is a possible (rare) complication of LASIK with use of the femtosecond laser (called "rainbow glare" and linked to a phenomenon of diffraction of light at the level of the interface of the hood). A balance sheet with topography and measure aberrometrique is required to quantify aberrations that you present, and estimate how much time (and late scarring) could mitigate them.
The size of the pupil decreases with age, I would like to know if it decreases in size in all the conditions of luminosities or only in the condition scotopical?
It seems that reduction of the pupillary diameter observed with age is global: but it is may be greater for mesopic/scotopic and photopic vision vision. However, the senile "myosis" is a significant reduction in the diameter of the pupil in terms photopiques (one to two millimeters) and which comes with a low reactivity to changes in brightness. Some have speculated that the reduction of the pupillary diameter was a natural adaptation of the eye to counter the rise of optical aberrations observed with age (of cristallinienne origin, mainly). Finally, note that after cataract surgery, there is most often a slight reduction in the diameter of the pupil.
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Learn more on the postoperative care after refractive surgery