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Hyperopia
surgery
LASIK · SMILE pro · Trans-PRK · ICL phakic lens · PreLex
Hyperopia (long-sightedness) tires the eyes before it blurs them. For years the eye compensates for it by focusing (accommodation). It comes to light with age, often just as presbyopia sets in. That is what makes its treatment different: the right solution depends a great deal on the age at which you decide to act.
Eligibility
Does this apply to you?
These criteria point the way; they do not decide. Only the pre-operative assessment, which measures the actual geometry of your eyes, can settle the question.
What the procedure corrects
Schematic cross-section: the difference in eye length is exaggerated
Favourable profile
- Aged 21 or over, with a prescription stable for at least two years
- Low to moderate hyperopia, for corneal laser treatment
- A regular cornea of sufficient thickness
- No keratoconus and no severe dry eye
- After 55, the natural lens has already stiffened: PreLex treats hyperopia and presbyopia in a single procedure
What rules it out or means waiting
- High hyperopia beyond what the laser can correct: a lens implant takes over
- A shallow anterior chamber, common in hyperopic eyes, which can rule out a phakic lens
- A narrow iridocorneal angle, always checked for by gonioscopy
- A prescription that is not yet stable, pregnancy or breastfeeding
- Keratoconus or an irregular cornea
Techniques
The options to consider.
None is better than the others in absolute terms: each one suits a specific anatomical situation.
LASIK
The reference technique for low to moderate hyperopia. The laser works on the corneal periphery to steepen the central curvature.
SMILE pro
Since 2024, lenticule extraction can also treat hyperopia up to seven dioptres, without cutting a flap. It requires a VisuMax 800 laser, and the surgical platform where I operate has one. Clinical follow-up is still short.
Trans-PKR
A surface alternative, for moderate corrections or for corneas that cannot take a flap.
ICL phakic lens
For high hyperopia. The depth of the anterior chamber, often reduced in hyperopic eyes, determines whether it is feasible.
PreLex
From age 55. The stiffened natural lens is replaced with a multifocal lens implant, which corrects hyperopia and presbyopia together.
What you should know
The point that rarely gets explained.
For a long time, SMILE treated only myopia. Since 2024, the SMILE pro module for hyperopia has had CE marking and treats up to seven dioptres, but only on the VisuMax 800 laser, which the surgical platform where I operate has. Its clinical track record is still short: LASIK remains the reference for hyperopia, with twenty-five years of data. And for a hyperopic patient over 50, the real question is often no longer whether to operate on the cornea, but whether to wait a few years and treat the natural lens.
SFO information leaflets (in French)
These leaflets are published by the Société Française d'Ophtalmologie (French Society of Ophthalmology). They describe the procedure, its results and its risks. They serve as the basis for informed consent and do not replace the consultation.
Frequently asked questions
What patients ask me most often.
Can SMILE correct hyperopia?
Yes, since 2024. The SMILE pro module for hyperopia has received CE marking and corrects up to seven dioptres, but it is only available on the VisuMax 800 laser. LASIK remains the reference technique, with a much longer clinical track record.
Why does hyperopia come to light with age?
The natural lens compensates for hyperopia by focusing (accommodating) all the time. As it loses its flexibility, it can no longer do so. That is when problems appear, first up close, then in the distance.
Should hyperopia be operated on after 55?
Often through the natural lens rather than the cornea. PreLex then corrects both hyperopia and presbyopia, and removes the possibility of a future cataract.
Does hyperopia get worse over time?
It does not really increase, but accommodation compensates for it less and less well, which for the patient amounts to the same thing.
Which tests decide whether surgery is possible?
Corneal topography, pachymetry, anterior chamber depth, gonioscopy and refraction under cycloplegia. That last one is essential in hyperopic eyes.
Find out whether it is possible for you
The questionnaire gives you a first indication in three minutes. The pre-operative assessment measures what cannot be guessed: your corneal topography, your corneal thickness and the condition of your retina.
Dr Emmanuel Halimi
Ophthalmic surgeon · RPPS 10100555084 · Medical Council of Hauts-de-Seine no. 92/23003
Page written and approved by the surgeon.
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