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FAQ Refractive Surgery

  • Why consider refractive laser surgery?

    Wearing glasses and lenses can sometimes cause problems. Glasses are not optimal for some leisure activities and especially for some sports. They can even be hindering in some professions (for instance for actors, cooks, police officers etc…). Esthetic matters can also speak against wearing glasses. But in most of those cases, contact lenses are a solution. Unfortunately, not everyone can wear contact lenses. They are often well-tolerated but after years, the lens becomes a foreign element to the eye, causing increasing irritation. The contact lens floats on the tear film. The quality of this tear film can also deteriorate with age. Allergies also restrict the use of contact lenses.
  • Who benefits from refractive laser surgery?

    Generally speaking, patients should consider refractive surgery only when they are not comfortable with glasses or contact lenses. To obtain an good result, you should fulfill the following requirements:
    • Your refraction is stable (during the last two years, your prescription values only
    Changed marginally)
    • You are at least 20 years of age
    • Your cornea has a sufficient thickness(will be measured during the pre-operative Test)
    • You are in a good condition and do not present, for instance, a rheumatic disorder.
    • Your eyes are healthy.
    • Allergies do not represent per se a contraindication but surgery should be avoided
    during an allergic episode.
  • Which patients cannot be operated?

    • Patients suffering from an ocular disorder, such as cataract, advanced glaucoma,
    corneal disorders, especially keratoconus or other corneal diseases.
    • Patients with unrealistic expectations. Every operation involves a risk. In the case of
    laser surgery, this risk is very low but you should be aware of it.
    • Patients insufficiently informed about the procedure, its benefit and its limits. As a
    precaution, it is preferable not to consider an operation during pregnancy and while breastfeeding. As a matter of fact, we will not be able to affirm whether or not your eyes can be treated by laser before performing an extensive examination.
  • Do I need to take precautions before surgery?

    You must stop wearing contact lenses for 14 days before the initial examination. Contact lenses modify the curvature of your cornea. After stopping wearing lenses and depending on their kind, the cornea may take several weeks to turn back to its natural curvature. If you did not stop the wearing contact lenses long enough before the initial examination, this will impair the precision of the surgical result. Consequently, please refrain from wearing lenses at least two weeks before the initial examination, whatever kind you are using. Between this examination and the operation day, you will be allowed to wear your lenses again. Do not wear them on the day of your surgery.
  • Do I need to take precautions on the day of surgery?

    • Do not use facial cream, lotion, make-up or perfume! These products can increase
    the infection risk or the surgery zone may be contaminated during and after the surgery.
    • The day of your surgery, carefully clean your eyelids and the region around your
    eyes, and do not wear your contact lenses.
    • Do not drive your own car.  On the day of surgery, your ability to drive may be
  • What are the different steps of LASIK surgery?

    After having anaesthetized your cornea with eye drops, we introduce a blepharostat in your eye to keep the eyelids open. During the whole duration of the treatment, the other eye is covered. The surgery itself takes less than 15 minutes.
  • Cutting the LASIK flap with the femtosecond laser

    We install a ring around the eye in order to keep it still during the preparation of the LASIK flap. The ring creates suction on the eye. During this suction, your vision will decrease and you will feel a certain pressure, but no pain. In a few seconds, the femtosecond laser, linked to the ring, cuts a thin layer of cornea (0.1 millimeter). After the cutting, your vision comes back but remains unclear. The operator lifts the corneal flap and folds it on its hinge.
  • The Excimer laser ablation

    A light now flashes above your eye and you should fix it. The flashing light may be sometimes difficult to see but you should however do your best to keep looking in its direction. Once your eye is in the right position, the operator starts the laser treatment. During 40 seconds at most, you will perceive unusual noises and smells. A computer integrated to the laser system controls the number and position of the laser pulses coming to your eye 750 times / second. If your eye moves a little during the procedure, the laser system detects those movements and readjusts the laser pulses accordingly (“eye tracking”). If eye movements are too important or fast, the laser system interrupts immediately. It will start again as soon as the eye reaches the correct position. This automatic control of your ocular movements is performed several hundred times per second. After the laser ablation, the operator puts the corneal flap back in place and carefully rinses the interface. At the end of the operation, the operator covers immediately your eye by a bandage lens and re-checks the corneal flap position. At this stage, your vision is very blurry, which is normal.
  • After the treatment

    Right after the treatment, you may have a burning sensation, itching or a foreign body sensation in your eye. Low pain can sometimes occur. It is generally due to the bandage lens that we will remove the day after surgery. BOTH eyes may be watery, red and your vision will probably be blurry. These symptoms will disappear in the first days after surgery. Generally speaking, during the weeks after surgery you should avoid any activity in the course of which your treated eye might receive a physical impact.
  • What can I expect in the first days / weeks / months?

    The first hours: during the hours following the surgery, your eye is watery and itches, your vision is blurry. Normally, you should not feel severe pain after a LASIK treatment. It is however normal after PRK. In case of strong pain or a sudden degradation of your vision, call your doctor. Be careful not to put water in the treated eye during washing or showering and do not rub your eyes. The first days: generally, the patient recovers to a visual acuity of 20 to 60% the day after the LASIK treatment; after PRK, one week is necessary. During the first days, avoid contact with water and animals and also do not rub your eyes. Do not do sports. The first weeks: vision stays variable during the first weeks and generally stabilizes at 4 to 6 weeks after LASIK treatment and at 2 to 3 months after PRK. During the two first weeks do not use cosmetics nor lotions on your eyes and around the eye. Do not practice contact sports (Karate, Squash…) for 4 weeks. In the first weeks and possibly during a few months, your eyes might feel dry. In this case we will prescribe you “artificial tears” that you will instill in your eyes as needed.
  • Is there a guarantee?

    After several months or years a given resurgence of the refractive defect cannot be excluded. Besides, it is not always possible to completely correct the visual error. Generally, the weaker the refractive defect before correction was, the greater the probability to completely correct the error for far vision. We cannot hence guarantee a complete independence of glasses for far vision but if they remain necessary, they will be much weaker than before surgery. Even if the operation is a complete success, you should expect to still need glasses for reading starting at the age of 45, when everybody becomes presbyopic.
  • Potential risks

    In their vast majority, patients are satisfied with refractive surgery and are impressed by the results. However, some risks must be taken into account during and after treatment.
  • Under- or overcorrection

    A solid proportion of our patients (90 to 98%, depending on the initial diopters) reaches 100% vision without supplementary correction by glasses or lenses. A fraction of patients will still need glasses after the treatment even though in this case, the dioptric power of the glasses will be low. This concerns mainly activities requiring an excellent vision (for instance driving). For astigmatic patients or patients who had very high corrections, results are often not as good as for patients whose visual error was not very pronounced. In most of the cases, a second intervention allows to overcome under- or overcorrection.
  • Dry eye

    During the first months, the surgery can induce a drop in tear production. In most cases, it improves during the first months. We will prescribe artificial tears during that period.
  • Keratitis (Sands of Sahara)

    Some patients develop an inflammation under the corneal flap. It is treated with anti-inflammatory eye drops and in a vast majority of cases; it does not leave any long-term sequels.
  • Keratectasia

    Keratectasia can occur if the cornea has lost its mechanical resistance because of the tissue ablation or the cuts performed; intraocular pressure pushes the weakened cornea to the front. A feared complication in the early days of refractive surgery, an increased risk for the development of keratectasia can nowadays be identified prior to surgery. Today, keratectasia is a very rare complication (1 case in around 1’500 procedures). If keratectasy should arise, the cornea can be reinforced by a cross-linking procedure.
  • Other complications

    Severe complications are extremely rare, less than one case of infection in 1’000 procedures is reported. With a mechanical microkeratom, a cutting error may occur in 1 to 3% of cases. This is the reason why we do not use this technique. With the femtosecond laser, there is no cutting error during the execution of the corneal flap. If the operator sees an irregularity at the end of the cutting, he will not lift the flap and will not proceed with the excimer laser treatment. The procedure can then be repeated after six weeks. In rare cases, the epithelium can proliferate under the corneal flap, what sometimes requires a new surgery. As a consequence of all these rare but possible complications, a decrease of vision occurs in less than 1% of the cases. Corrections can further reduce this number. Procedure Cost: At the Eye, we want to offer you the highest quality, best service and hi-tech at a fair price.The costs for your refractive laser treatment are aligned to the method of treatment suitable for you and your personal diopter values. You will find out the exact cost of treatment after the detailed preliminary examination.
  • LASIK Complications

    LASIK complications can occur. You should be informed of all possible LASIK complications. However, the purpose of this information is not to terrorize patients by suggesting grotesque consequences. We would like to emphasize the rarity of the LASIK complications mentioned below. However, it is good for the patient to be sensitized to the fact that complications can occur, and that in fact, most complications have easy solutions. It is also important to remember that these are complications after conventional LASIK. Bladeless LASIK (or Blade Free LASIK) and ReLEx smile are much safer. Indeed, it is extremely rare to find complications with bladeless LASIK and ReLEx smile. The first possible Lasik complication an eye(s) infection immediately following the procedure. We take due care to ensure that infections don’t get introduced into the eye as a result of the procedure itself. It is important that patients also follow instructions from the center’s staff and doctors carefully. Infections can be controlled by instilling antibiotic eye drops and other medicines. However, in extremely rare cases, severe loss of vision is possible, if an infection does occur. The second possible Lasik complication is the rare occurrence in which there are problems in fashioning the flap. This may include an incomplete flap, or a free cap oran irregular flap. Generally, the solution of these complications is to postpone the surgery and repeat it after 3 months, with little or no adverse consequences. By using Blade Free Procedures, (for e.g. by using the femtosecond laser), flap making complications can be greatly reduced. The third Lasik complication is in the flap-bed interface following LASIK. Sometimes, there can be inflammation in the interface, leading to a drop in vision. Sometimes, cells from the top surface of the flap (epithelium) migrate to the interface and grow there. Most times, lifting the flap and washing can solve these problems. In rare cases, the flap may need to be cut away (in which case, it becomes a PRK like procedure). In extremely rare cases, a corneal transplant may become necessary. Another complication of LASIK is kerastecsia, or a bulging forward of the cornea due to excessive thinning. While we take care not to excessively thin the cornea, in rare cases, it can be spontaneous. This condition may lead to a severe drop in vision, and may be helped by wearing hard contact lenses or a corneal transplant. 1Another complications of LASIK include under correction or overcorrection (which may require an enhancement procedure), glare or haloes around lights, especially at night, dry eyes, and an increased sensitivity to pain. In rare cases, the flap may shear off due to trauma suffered even several years after the procedure. LASIK Complication involving a displaced flap and wrinkling of the flap In ReLEx smile, no flap is created. This is a significant advantage of ReLEx smile, especially for people who work in physically challenging environments, like contact sports, security services, army, railway, factories and so on. All this information is available in our informed consent form, which you will be required to sign before you. 1