Refractive Surgery
The excimer laser used for refractive surgery is a gas-laser able to remodel the cornea by photo-ablation, with a precision of a micron.
There are two ways of using the excimer laser :
The Lasik
The laser creates a lamellar flap in the cornea, 100um thick (as thin as a contact lens). The step is 30 seconds long. The corneal flap is then flipped onto its side in order to leave access for the laser to the deep layers of the cornea.
Then the laser “sculpts” the cornea, in order to modify its curvature radius. Each laser impact removes 0,25 microns of corneal tissue. The “shape” of the sculpture (called “ablation profile”) is adapted to the visual condition to be treated.
The corneal flap is then put back in place and sticks within a few minutes. It then scars without any suture.
The LASIK procedure does not contraindicate another procedure of the eye (intra-ocular lens, cataract surgery, corneal incisions)
The PRK
The refractive photokeratectomy or PRK is a treatment in which the excimer laser treats directly the cornea without creating a flap beforehand. It is therefore called a surface treatment.
The PRK is quickly done, not painful at all, but because the epithelium is removed, the patient has to wear contact lenses during a few days after the procedure. These have an antalgic effect and improve the scaring.
PRK is recommended for patients with thin cornea and also in other circumstances.
The choice between one or the other of these procedures is determined by the pre-operative measurements.
There are two ways of using the excimer laser :
The Lasik
The laser creates a lamellar flap in the cornea, 100um thick (as thin as a contact lens). The step is 30 seconds long. The corneal flap is then flipped onto its side in order to leave access for the laser to the deep layers of the cornea.
Then the laser “sculpts” the cornea, in order to modify its curvature radius. Each laser impact removes 0,25 microns of corneal tissue. The “shape” of the sculpture (called “ablation profile”) is adapted to the visual condition to be treated.
The corneal flap is then put back in place and sticks within a few minutes. It then scars without any suture.
The LASIK procedure does not contraindicate another procedure of the eye (intra-ocular lens, cataract surgery, corneal incisions)
The PRK
The refractive photokeratectomy or PRK is a treatment in which the excimer laser treats directly the cornea without creating a flap beforehand. It is therefore called a surface treatment.
The PRK is quickly done, not painful at all, but because the epithelium is removed, the patient has to wear contact lenses during a few days after the procedure. These have an antalgic effect and improve the scaring.
PRK is recommended for patients with thin cornea and also in other circumstances.
The choice between one or the other of these procedures is determined by the pre-operative measurements.
Pre-operative measurements
Your visual condition must be stable for at least 2 years. The myopia’s stabilisation usually occurs after the age of 20 or even 25. In doubt, at the end of the pre-operative measurements, another appointment will be given to you 6 months later in order to judge if the procedure can safely take place.
The first step is a pre-operative appointment to assess eyes that could be at risk of being weakened by the procedure. Then, if the procedure is considered possible, the decision is taken for the most appropriate technique during this appointment.
You must remove your contact lenses before any measurements:
- at least 2 days before if you wear soft contact lenses,
- at least 1 week before if you wear hard, rigid or semi-rigid contact lenses.
at least 1 week before if you wear hard, rigid or semi-rigid contact lenses If you have a former glasses prescription, it must be brought to the pre-operative appointment.
During the pre-operative appointment, your eye might need to be dilated. This dilation can last for hours. It might be difficult to read until the next morning. The pre-operative appointment is quite long, so try driving is not recommended.
At the end of this pre-operative assessment, your surgeon will give explanations and a leaflet with some information that will help you to decide, considering all the consequences of such a surgery. The benefits and risks must be explained to you (there is no surgery without risk, even small ones).
You can ask all the questions that you want. At the end, all the essential papers will be given to you. One of them is the “informed consent”. This consent must be read and signed by each patient before the procedure. This document is not a responsibility discharge but it proves that you received exhaustive information about the procedure and that you understood it.
It is perfectly possible to take time to think about the procedure as the measurements are valid for several months. A prescription with the premedication for the surgery could be given to you.
The first step is a pre-operative appointment to assess eyes that could be at risk of being weakened by the procedure. Then, if the procedure is considered possible, the decision is taken for the most appropriate technique during this appointment.
You must remove your contact lenses before any measurements:
- at least 2 days before if you wear soft contact lenses,
- at least 1 week before if you wear hard, rigid or semi-rigid contact lenses.
at least 1 week before if you wear hard, rigid or semi-rigid contact lenses If you have a former glasses prescription, it must be brought to the pre-operative appointment.
During the pre-operative appointment, your eye might need to be dilated. This dilation can last for hours. It might be difficult to read until the next morning. The pre-operative appointment is quite long, so try driving is not recommended.
At the end of this pre-operative assessment, your surgeon will give explanations and a leaflet with some information that will help you to decide, considering all the consequences of such a surgery. The benefits and risks must be explained to you (there is no surgery without risk, even small ones).
You can ask all the questions that you want. At the end, all the essential papers will be given to you. One of them is the “informed consent”. This consent must be read and signed by each patient before the procedure. This document is not a responsibility discharge but it proves that you received exhaustive information about the procedure and that you understood it.
It is perfectly possible to take time to think about the procedure as the measurements are valid for several months. A prescription with the premedication for the surgery could be given to you.
Steps of the surgery
The surgery is a day-care one, this means you don’t need to stay at the surgery site.
When admitting you, we will ask you for the consent form, signed by you that we gave you at the time of the pre-operative assessment.
The surgery will take place under local anaesthesia, with the instillation of drops in your eyes. The anaesthesia is done in the theatre, a few minutes before your surgery. Once the surgery is done, you will have a plastic protection taped onto your eye or your own sunglasses as a protection. Then you can go back home and the next control will take place 48 hours later.
A prescription will be given to you with the medical instructions for the next days.
When admitting you, we will ask you for the consent form, signed by you that we gave you at the time of the pre-operative assessment.
The surgery will take place under local anaesthesia, with the instillation of drops in your eyes. The anaesthesia is done in the theatre, a few minutes before your surgery. Once the surgery is done, you will have a plastic protection taped onto your eye or your own sunglasses as a protection. Then you can go back home and the next control will take place 48 hours later.
A prescription will be given to you with the medical instructions for the next days.
Pre-operative precautions
You must absolutely stop wearing your contact lenses at least one week before the surgery.
It’s forbidden to put make-up on the eyelashes and lids the day before and the day of the surgery and even the week after the surgery. No perfume on the day of the surgery.
It is recommended to come with someone who can take you back home after the procedure.
It’s forbidden to put make-up on the eyelashes and lids the day before and the day of the surgery and even the week after the surgery. No perfume on the day of the surgery.
It is recommended to come with someone who can take you back home after the procedure.
Post-operative follow-up
A post-operative appointment is made for the day after the procedure by your surgeon.
The day after a LASIK procedure, it is possible to perform most of your normal day activities.
Makeup of the eyelashes and lids is totally forbidden for the week after the procedure. Sports with possible contact and Scuba diving are to be avoided during the 4 weeks following the surgery.
The day after a LASIK procedure, it is possible to perform most of your normal day activities.
Makeup of the eyelashes and lids is totally forbidden for the week after the procedure. Sports with possible contact and Scuba diving are to be avoided during the 4 weeks following the surgery.