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Myopia
surgery
LASIK · SMILE · Trans-PRK · ICL phakic lens
Myopia (short-sightedness) is the condition most often operated on, and the one where results are most predictable. There are four techniques: three work on the cornea with a laser, one places a lens implant inside the eye. The assessment points to the one that suits your eyes, not the other way round.
Eligibility
Does this apply to you?
These criteria give a direction; they do not decide. Only the pre-operative assessment, which measures the actual geometry of your eyes, can settle the question.
What the operation corrects
Schematic cross-section: the difference in eye length is exaggerated
Favourable profile
- Aged 21 or over, with a refraction stable for at least two years
- Cornea of regular thickness and shape, checked by topography and pachymetry
- No keratoconus, either personal or in the family
- Tear film of sufficient quality, or dry eye treated beforehand
- Normal dilated eye examination: high myopia carries a risk of peripheral retinal lesions
- Realistic expectations, and acceptance that some additional correction may be needed after 45
What rules it out or means waiting
- Refraction still changing: two years of stability are a prerequisite
- Keratoconus, or suspected keratoconus on topography
- Cornea too thin for the intended correction: the lens implant then becomes the option
- Current pregnancy or breastfeeding
- Uncontrolled autoimmune disease, isotretinoin treatment
- Early cataract: in that case it is the natural lens that needs treating
Techniques
The possible options.
None is better than the others in absolute terms: each one fits a specific anatomical situation.
LASIK
Low to moderate myopia, on a cornea of sufficient thickness. Vision recovers from the next day.
SMILE
Myopia with or without astigmatism, with no corneal flap cut. The structure of the cornea is better preserved, with less dry eye.
Trans-PRK
Thin corneas, contact sports, occupations with a risk of eye injury. Longer recovery, five to seven days.
ICL phakic lens
High myopia above six dioptres, or a cornea too thin for laser. The cornea is left untouched and the lens can be removed.
What you should know
The point that is too rarely explained.
The vast majority of patients operated on for low to moderate myopia no longer need glasses or contact lenses for driving, sport and everyday life. After 45, presbyopia will appear all the same: the operation corrects myopia, it does not stop the natural lens from ageing. This is the point on which expectations have to be set beforehand, not discovered afterwards.
SFO information leaflets (in French)
Published by the French Society of Ophthalmology (Société Française d'Ophtalmologie, SFO), these leaflets describe the operation, its results and its risks. They form the basis of informed consent and do not replace the consultation.
Frequently asked questions
What I am asked most often.
From what age can myopia be operated on?
Twenty-one, with a refraction that has been stable for at least two years. Before that age, myopia is still progressing and the result would deteriorate.
What if my cornea is too thin for laser?
The ICL phakic lens is designed precisely for this situation: it corrects myopia without touching the cornea, and it can be removed.
Can myopia come back after the operation?
The correction stays stable over time if the refraction was stable beforehand. Myopia that is still progressing at the time of surgery, on the other hand, will keep progressing.
Is myopia surgery painful?
No. Anaesthesia is given with eye drops and the procedure itself is painless. After Trans-PRK, however, significant discomfort is common for the first three to five days.
Should both eyes be operated on the same day?
For laser, yes in most cases. For the phakic lens, the two eyes are operated on one week apart.
Find out whether it is possible for you
The questionnaire gives 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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