Docteur Dr Marc Weiser - 61 rue de Rennes 75006 Paris - Téléphone : 01 45 48 31 13 FR EN
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Myopia

Definition

Myopia or nearsightedness occurs if the eyeball is too long and/or the cornea has too much curvature. As a result, the light becomes focused in front of the retina, causing distant objects to look blurred. People suffering from myopia have a diminished long-sighted vision, and represent approximately 20% of adults in France.

If not operated, nearsighted people will always retain their uncorrected near vision, even around the age where most suffer from presbyopia.

Several surgical procedures are available. If you are over 40 years of age you may benefit from a combined procedure that can simultaneously correct presbyopia (to learn more about presbyopia please refer to the chapter presbyopia).

 

Myopia
Myopie myope Paris

Myopia

Definition

Myopia or nearsightedness occurs if the eyeball is too long and/or the cornea has too much curvature. As a result, the light becomes focused in front of the retina, causing distant objects to look blurred. People suffering from myopia have a diminished long-sighted vision, and represent approximately 20% of adults in France.

If not operated, nearsighted people will always retain their uncorrected near vision, even around the age where most suffer from presbyopia.

Several surgical procedures are available. If you are over 40 years of age you may benefit from a combined procedure that can simultaneously correct presbyopia (to learn more about presbyopia please refer to the chapter presbyopia).

 

Myopia
Myopie myope Paris

LASIK (Laser Assisted In Situ Keratomileusis)

LASIK is a mixed technique combining two lasers : a femtosecond laser followed by an excimer laser. The femtosecond laser cuts tissues, and creates a flap inside the cornea ; the excimer laser consists in a powerful beam of ultraviolet light guided by a computer, and flattens the cornea to treat myopia. I use in our facility several femtosecond and excimer lasers, allowing me to choose the most appropriate laser for each single patient.

The procedure is performed under local anaesthesia in an outpatient facility, and rarely exceeds thirty minutes for both eyes. The application of each laser beam takes less than one minute. The perfect balancing of the treatment is performed automatically, with the aid of an infrared camera. The corneal flap is then replaced at the end of the surgery, and immediately adheres to the deep layer of the cornea. No sutures are necessary. A local postoperative treatment is generally prescribed for a few weeks after the surgery.

A foreign body sensation in the operated eyes may last a few days. A touch-up is sometimes necessary after a few months to treat a decentered ablation or an over/undercorrection. For the latter, the surgeon simply needs to lift the flap initially made and reapply the excimer laser, before repositioning the flap. In very rare cases, cells from the corneal coating can migrate into the interface along with debris, which can potentially impact visual outcome. A touch-up is once again needed and consists in lifting the initial corneal flap, cleaning the interface and reapplying the flap.

LASIK is an extremely safe procedure and the results are independent from patient cooperation. The visual recovery is very fast, rarely exceeding 24 hours, allowing the patient to resume a normal life the day after surgery. LASIK is therefore the technique of choice, whenever possible and safe.

 

Visumax Plateform
lasik Paris

 

Intralase Femtosecond Laser
lasik Paris

 

Laser Excimer Teneo 2 Bausch & Lomblasik Paris

 

Lasik
lasik Paris

LASIK (Laser Assisted In Situ Keratomileusis)

LASIK is a mixed technique combining two lasers : a femtosecond laser followed by an excimer laser. The femtosecond laser cuts tissues, and creates a flap inside the cornea ; the excimer laser consists in a powerful beam of ultraviolet light guided by a computer, and flattens the cornea to treat myopia. I use in our facility several femtosecond and excimer lasers, allowing me to choose the most appropriate laser for each single patient.

The procedure is performed under local anaesthesia in an outpatient facility, and rarely exceeds thirty minutes for both eyes. The application of each laser beam takes less than one minute. The perfect balancing of the treatment is performed automatically, with the aid of an infrared camera. The corneal flap is then replaced at the end of the surgery, and immediately adheres to the deep layer of the cornea. No sutures are necessary. A local postoperative treatment is generally prescribed for a few weeks after the surgery.

A foreign body sensation in the operated eyes may last a few days. A touch-up is sometimes necessary after a few months to treat a decentered ablation or an over/undercorrection. For the latter, the surgeon simply needs to lift the flap initially made and reapply the excimer laser, before repositioning the flap. In very rare cases, cells from the corneal coating can migrate into the interface along with debris, which can potentially impact visual outcome. A touch-up is once again needed and consists in lifting the initial corneal flap, cleaning the interface and reapplying the flap.

LASIK is an extremely safe procedure and the results are independent from patient cooperation. The visual recovery is very fast, rarely exceeding 24 hours, allowing the patient to resume a normal life the day after surgery. LASIK is therefore the technique of choice, whenever possible and safe.

 

Visumax Plateform
lasik Paris

 

Intralase Femtosecond Laser
lasik Paris

 

Laser Excimer Teneo 2 Bausch & Lomblasik Paris

 

Lasik
lasik Paris

PRK (Photo Refractive Keratectomy)

The procedure is quite the same but instead of creating a flap inside the cornea, the excimer beam energy is delivered on top of the corneal surface after its superficial layer (epithelium) has been peeled.

Postoperative pain is frequently observed for the first twenty-four to forty-eight hours. A bandage contact lens is placed over the cornea for a couple of days and nights in order to help reducing pain. A local treatment with eye drops is prescribed for a few weeks to a few months after the surgery.

Instead of LASIK fast visual recovery, clear vision is obtained in PRK after a period of one to two weeks. In very rare cases, a touch-up is needed to address the following issues: shifting (which may lead to daytime glare and/or feelings of diplopia when it is sufficiently sizeable), undercorrection, overcorrection, or excessive scarring resulting in corneal opacity (haze) which can limit the degree of visual recovery and lead to a recurrence of the preoperative refractive problem.

Due to delayed visual recovery PRK is a good alternative for low myopic patients who are not good candidates for LASIK. Moreover PRK does not weaken the eyeball and thus allow the practice of all sports, even violent.

PRK (Photo Refractive Keratectomy)

The procedure is quite the same but instead of creating a flap inside the cornea, the excimer beam energy is delivered on top of the corneal surface after its superficial layer (epithelium) has been peeled.

Postoperative pain is frequently observed for the first twenty-four to forty-eight hours. A bandage contact lens is placed over the cornea for a couple of days and nights in order to help reducing pain. A local treatment with eye drops is prescribed for a few weeks to a few months after the surgery.

Instead of LASIK fast visual recovery, clear vision is obtained in PRK after a period of one to two weeks. In very rare cases, a touch-up is needed to address the following issues: shifting (which may lead to daytime glare and/or feelings of diplopia when it is sufficiently sizeable), undercorrection, overcorrection, or excessive scarring resulting in corneal opacity (haze) which can limit the degree of visual recovery and lead to a recurrence of the preoperative refractive problem.

Due to delayed visual recovery PRK is a good alternative for low myopic patients who are not good candidates for LASIK. Moreover PRK does not weaken the eyeball and thus allow the practice of all sports, even violent.

EPILASIK

This technique combines surgery and excimer laser, and is meant to cure stronger forms of myopia which cannot be treated by LASIK. The corneal flap is thinner than with that which is needed for LASIK surgery. This technique, intended for thin corneas, is in fact very close to PRK in terms of the procedure itself and of the delay of visual recovery. 

EPILASIK

This technique combines surgery and excimer laser, and is meant to cure stronger forms of myopia which cannot be treated by LASIK. The corneal flap is thinner than with that which is needed for LASIK surgery. This technique, intended for thin corneas, is in fact very close to PRK in terms of the procedure itself and of the delay of visual recovery. 

SMILE (Small Incision Lenticule Extraction)

SMILE is an alternative to LASIK to cure myopia of 4 to 10 diopters, and is specifically recommended for patients with thinner corneas or for those practicing combat sports such as boxing.

The surgical procedure is performed with a femtosecond Visumax laser developed by Carl Zeiss Meditec. The surgeon applies the laser beam twice, with each application being separated by a thickness proportional to the desired refractive effect. The corneal stroma is thus cut and manually extracted through an incision of 3.5 to 4mm. This technique requires a certain surgical skill.

 

 

Plateforme Visumax

SMILE (Small Incision Lenticule Extraction)

SMILE is an alternative to LASIK to cure myopia of 4 to 10 diopters, and is specifically recommended for patients with thinner corneas or for those practicing combat sports such as boxing.

The surgical procedure is performed with a femtosecond Visumax laser developed by Carl Zeiss Meditec. The surgeon applies the laser beam twice, with each application being separated by a thickness proportional to the desired refractive effect. The corneal stroma is thus cut and manually extracted through an incision of 3.5 to 4mm. This technique requires a certain surgical skill.

 

 

Plateforme Visumax

Intra ocular lenses

High-degree myopia can be treated with the use of intraocular implants. The procedure consists in placing an additional lens either inside the eye in front of the human lens in order to correct the refractive error. The power of the implant is chosen based on the desired correction, and the accuracy of the result is excellent. Both the size and power of the implant are determined on a customized basis, depending on the preoperative measurements.

The procedure is performed under local anaesthesia (by drops) in an outpatient facility, and rarely exceeds one hour for both eyes. The visual recovery is very fast, as LASIK, rarely exceeding 24 hours, and allows the patient to resume a normal life the day after surgery. The advantage of this technique is also its reversibility, along with the possibility of resorting, if required, to another type of surgery several years down the road.

 

Intra ocular lenses

High-degree myopia can be treated with the use of intraocular implants. The procedure consists in placing an additional lens either inside the eye in front of the human lens in order to correct the refractive error. The power of the implant is chosen based on the desired correction, and the accuracy of the result is excellent. Both the size and power of the implant are determined on a customized basis, depending on the preoperative measurements.

The procedure is performed under local anaesthesia (by drops) in an outpatient facility, and rarely exceeds one hour for both eyes. The visual recovery is very fast, as LASIK, rarely exceeding 24 hours, and allows the patient to resume a normal life the day after surgery. The advantage of this technique is also its reversibility, along with the possibility of resorting, if required, to another type of surgery several years down the road.

 

FAQ Myopia

1/ Is there a minimal age for surgery?

The key issue is not age but myopia stabilization; at least 2 years of stable refraction are required prior to surgery decision. Each single myopia has a different scalable profile, which has to be taken in account.

However it may be useful to perform surgery on unstable myopias, in cases of particular professional requests (entry into the army, police, and so on); in such cases secondary optic correction will be necessary and reoperation considered after myopic stability achievement.

2/ Is there an age beyond which it is no longer possible to have surgery?

No there is no limit in age.

However age and potential concomitant presbyopia may influence surgical feasibility as well as the choice of the surgical technique.

3/ Are all patients operable?

No, there are several contraindications. It is the main purpose of preoperative consultation to detect and eliminate unappropriate candidates.

Some patients are not operable at all; others are only eligible for specific techniques. For instance too thin corneas contraindicate LASIK but allow PRK or placement of an intra ocular lens. Therefore your surgeon must have the ability to indifferently perform all surgical procedures in order to let you benefit from the most appropriate one.

4/ Is it possible to have surgery performed before being pregnant?

Yes in a vast majority of stable myopia cases, in contrary to the misconception that pregnancy would increase myopia.

In fact pregnancy does not create per se myopic progression, except rare cases of very high myopias. Hormonal changing during pregnancy may simply have a transitory and reversible effect upon vision.

On the other hand it is contraindicated to operate a woman during pregnancy and breastfeeding until normal menstrual cycles return.

5/ How long should the contact lenses should be removed before surgery?

Contact lens removal is mandatory 48 hours before surgery in case of soft contact lenses, 1 month in case of rigid contact (it is possible to temporarily replace them by soft ones which will be removed 48 hours before surgery).

6/ How is surgery performed?

Surgery is performed under local anaesthesia, by anaesthetic drops instillation. In contrary to popular belief there is no injection in the eye. Oral sedation is given two hours prior to surgery, in order to manage legitimate apprehension.

Both eyes have surgery in the same operative session. The procedure is fully painless and lasts about 30 minutes. The patient is discharged one hour later and should be taken home back by a relative. Driving is not permitted the day of surgery.

7/ Is surgery risky?

Myopia refractive surgery is extremely safe, provided common sense rules are respected, rules that I have been uncompromisingly following during all my practice: rigorous and appropriate patient selection with absolute respect of all contraindications, use of last generation measurement devices and lasers, operating rooms with highest security standards.

Side effects may happen in the following weeks (glare, vision fluctuation, halos); usually minor and impermanent, they do not impact final visual result, even if rarely a touch up may be needed. Surprisingly surgery is less risky than contact lens wearing, especially in terms of infectious risk. This type of surgery has now a long follow-up and has demonstrated its maturity and safety.

8/ Is there any pain after surgery? What is the visual recovery time?

These issues are correlated to the procedure.

LASIK, SMILE, and intra ocular lenses cause more discomfort than true pain; visual rehabilitation is fast, taking several hours to one day.

Visual recovery is longer for PRK and EPILASIK and can take a week. For both techniques discomfort may be more pronounced; in order to prevent true pain a bandage contact lens is placed for a couple of days, and the patient is given oral analgesic pills.

Visual result is stable with time, as long as preoperative myopia has reached stability.

9/ Which are the prohibited activities after surgery?

Resume work and driving are fully permitted the day after surgery for LASIK, SMILE, and intra ocular lenses. Both are one week delayed after PRK and EPILASIK. Swimming and combat sports should not be practiced during a month regardless the technique.

Make-up is permitted after a week, as well as sun exposure, provided sunglasses are worn.

Rehabilitation is therefore extremely fast, for patient major happiness and satisfaction.

FAQ Myopia

1/ Is there a minimal age for surgery?

The key issue is not age but myopia stabilization; at least 2 years of stable refraction are required prior to surgery decision. Each single myopia has a different scalable profile, which has to be taken in account.

However it may be useful to perform surgery on unstable myopias, in cases of particular professional requests (entry into the army, police, and so on); in such cases secondary optic correction will be necessary and reoperation considered after myopic stability achievement.

2/ Is there an age beyond which it is no longer possible to have surgery?

No there is no limit in age.

However age and potential concomitant presbyopia may influence surgical feasibility as well as the choice of the surgical technique.

3/ Are all patients operable?

No, there are several contraindications. It is the main purpose of preoperative consultation to detect and eliminate unappropriate candidates.

Some patients are not operable at all; others are only eligible for specific techniques. For instance too thin corneas contraindicate LASIK but allow PRK or placement of an intra ocular lens. Therefore your surgeon must have the ability to indifferently perform all surgical procedures in order to let you benefit from the most appropriate one.

4/ Is it possible to have surgery performed before being pregnant?

Yes in a vast majority of stable myopia cases, in contrary to the misconception that pregnancy would increase myopia.

In fact pregnancy does not create per se myopic progression, except rare cases of very high myopias. Hormonal changing during pregnancy may simply have a transitory and reversible effect upon vision.

On the other hand it is contraindicated to operate a woman during pregnancy and breastfeeding until normal menstrual cycles return.

5/ How long should the contact lenses should be removed before surgery?

Contact lens removal is mandatory 48 hours before surgery in case of soft contact lenses, 1 month in case of rigid contact (it is possible to temporarily replace them by soft ones which will be removed 48 hours before surgery).

6/ How is surgery performed?

Surgery is performed under local anaesthesia, by anaesthetic drops instillation. In contrary to popular belief there is no injection in the eye. Oral sedation is given two hours prior to surgery, in order to manage legitimate apprehension.

Both eyes have surgery in the same operative session. The procedure is fully painless and lasts about 30 minutes. The patient is discharged one hour later and should be taken home back by a relative. Driving is not permitted the day of surgery.

7/ Is surgery risky?

Myopia refractive surgery is extremely safe, provided common sense rules are respected, rules that I have been uncompromisingly following during all my practice: rigorous and appropriate patient selection with absolute respect of all contraindications, use of last generation measurement devices and lasers, operating rooms with highest security standards.

Side effects may happen in the following weeks (glare, vision fluctuation, halos); usually minor and impermanent, they do not impact final visual result, even if rarely a touch up may be needed. Surprisingly surgery is less risky than contact lens wearing, especially in terms of infectious risk. This type of surgery has now a long follow-up and has demonstrated its maturity and safety.

8/ Is there any pain after surgery? What is the visual recovery time?

These issues are correlated to the procedure.

LASIK, SMILE, and intra ocular lenses cause more discomfort than true pain; visual rehabilitation is fast, taking several hours to one day.

Visual recovery is longer for PRK and EPILASIK and can take a week. For both techniques discomfort may be more pronounced; in order to prevent true pain a bandage contact lens is placed for a couple of days, and the patient is given oral analgesic pills.

Visual result is stable with time, as long as preoperative myopia has reached stability.

9/ Which are the prohibited activities after surgery?

Resume work and driving are fully permitted the day after surgery for LASIK, SMILE, and intra ocular lenses. Both are one week delayed after PRK and EPILASIK. Swimming and combat sports should not be practiced during a month regardless the technique.

Make-up is permitted after a week, as well as sun exposure, provided sunglasses are worn.

Rehabilitation is therefore extremely fast, for patient major happiness and satisfaction.

WEARING GLASSES AND/OR CONTACT LENSES IS NOT ANYMORE A FATALITY


myope paris ophtalmologie

YOU ARE SUFFERING
FROM MYOPIA

hypermetrope paris ophtalmologie

YOU ARE SUFFERING
FROM HYPEROPIA

presbyte paris ophtalmologie

YOU ARE SUFFERING
FROM PRESBYOPIA

astigmate paris ophtalmologie

YOU ARE SUFFERING
FROM ASTIGMATISM

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SCHEDULE YOUR APPOINTMENT WITH DR. WEISER


PRACTICE

61 rue de Rennes
75006 Paris

Phone : +33 (0)1 45 48 31 13

Consultations and preoperative explorations.

CLINIQUE DE LA VISION

131 rue de l’Université
75007 PARIS

Phone : +33 (0)1 58 05 20 00

Refractive Surgery. Surgery on Thursdays

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18 rue Jouvenet
75016 PARIS

Phone : +33 (0)1 42 15 41 19

Cataract, glaucoma, cornea...
Surgery on Monday afternoons, Tuesday afternoons and Wednesday mornings.

astigmate paris ophtalmologie

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This site only presents information on anterior segment surgeries, such as refractive, cataract, and glaucoma surgery. It does not include advertising. It refers only to recognized methods, proven by a vast majority of specialists. Its contents may not be exhaustive as recommended by the French administration. The responsibility of the website solely belongs to his author, Marc Weiser, M.D. Our privacy policy.

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