Astigmatism is not a disease but a vision disorder or, more scientifically, a refraction disorder. As such, astigmatism has three “cousins”: short-sightedness, far-sightedness and presbyopia.
Astigmatism is characterised by a deformation of the cornea. In the case of a normal eye, the cornea has the same curvature in all directions. It is this regularity that enables you to perceive an image clearly. However, when you suffer from astigmatism, the curvature of the cornea is more pronounced in one direction than another. So the cornea becomes the shape of a rugby ball rather than a lovely round football.
Astigmatism is often accompanied by short-sightedness and far-sightedness.
A person with astigmatism has blurred and indistinct vision both long distance and close up. He has difficulty in perceiving shapes, images are unclear or deformed. He easily confuses letters or round numbers like 3, 6, 8 and 9.
A person with astigmatism may also suffer from headaches, eye tiredness, redness in the eyes and a burning feeling.
Pronounced astigmatism is generally hereditary.
Astigmatism does not worsen with age, as it is linked to the cornea curvatures which – excepting in the case of certain diseases like keratoconus – remain stable.
Astigmatism is diagnosed by a clinical examination by an ophthalmologist.
Unfortunately there is no way of preventing astigmatism.
Fortunately there are many solutions for astigmatism: contact lenses, cylindrical glasses, laser surgery, eye exercises.
LASIK is a surgical technique that enables most refractive errors to be corrected. This technique offers extremely good results. Better still, LASIK is virtually painless and offers a functional result right from the following day. LASIK is therefore the ‘gold-standard’ treatment for anyone suffering from short-sightedness, far-sightedness or astigmatism.
Current lasers have a one millimetre diameter ray, which enables the surface of the cornea to be modified with sub-micrometre precision. This technique guarantees reliable results from a safety, stability and effectiveness point of view.
LASIK enables treating short-sightedness (up to a dioptre of -12), astigmatism (up to a dioptre of 6) and far-sightedness (up to a dioptre of +6). We are now also able to correct irregular astigmatisms due to LASIK.
LASIK is a complete alternative to glasses and contact lenses. Its benefits are irrefutable:
very fast healing
quick results
an almost painless treatment
LASIK treatment is done under local anaesthetic. It lasts about ten minutes per eye. Both eyes are treated during the same surgical operation. When the operation is carried out by an experienced surgeon, the surgical risks, inherent in each operation, are extremely limited with the LASIK technique.
The surgery is done on an outpatient basis under topical anaesthetic (only drops) and lasts 10 minutes.
With short-sightedness, the laser flattens the surface of the central cornea. With far-sightedness, it removes a ring of tissue around the optic zone, so this will arch back. The endothelial pump will contribute to the flap’s adhesion to the bed of the cornea: sutures are not necessary. This technique enables rapid healing with optimum comfort for the patient.
Compared with PRK (photorefractive Keratectomy), the healing process and inflammatory reaction are significantly reduced with LASIK: the cornea’s epithelium and the Bowman membrane remain preserved and the surface layer of the cornea is less disturbed as a refraction surface.
There is no sub epithelial haze (abnormal scar)
The corneal stroma shows no scarring reaction
As healing is very fast, functional recovery of visual acuity occurs right from the day after the operation. A temporary loss of sensitivity to contrasts may initially make reading more difficult. Post-operative pain is less.
During the operation, several safety controls are built into the keratome assembly and surgical protocol. Keratomes that can be arranged in a block enable this assembly to be simplified.
Is a person operated on for short-sightedness, far-sightedness and/or astigmatism able to have better vision than a person who has never needed glasses?
Optical customised ablation (optical customization) enables the cornea to be treated in terms of corneal aberrations or eye aberrations as a whole. Two different techniques are described:
Topography guided ablations: this technique enables treating patients with regular or irregular astigmatisms (from birth or induced) or – after previous surgery – central islands, decentring and/or reduced optic zones. The topographer’s measurements are transmitted to the laser which is going to be able to transform the cornea by “ablating” the areas defined by the surgeon.
Wavefront analysis guided ablations. This technique consists of studying eye aberrations by means of a wavefront analyser and transmitting the corrections to be made to the eye to the laser in order to remove its low and high degree aberrations.
In the case of primary treatments, customised ablation offers significant benefits:
a greater chance of obtaining 10/10 or better than 10/10 visual acuity
a reduced risk of loss of better corrected visual acuity
a more even cornea and a larger optic zone and therefore a reduced risk of loss of sensitivity to contrasts or night time vision
Customised LASIK also offers new possibilities for patients who have already undergone refractive surgery and who complain of significant problems (halos, glare, etc.) arising from optical aberrations caused by decentring, inadequate optic zones, central islands and/or irregular astigmatisms. In some cases, they may benefit from topography guided or wavefront guided treatment. Customised treatment enables the cornea to be made more regular by decreasing the cornea’s aberrations and enlarging the optic zone. So the patient has a greater chance or regaining a better corrected visual acuity.
Customised LASIK involves a complete examination of the patient’s individual eye using an in-depth topographic analysis of the cornea and an analysis of optical aberration by wavefront analysis. The laser beam will then be guided by this information that reflects the unique characteristics of the patient’s eye.
The benefits of customised LASIK are:
a greater chance of obtaining 10/10 or better than 10/10 visual acuity
a reduced risk of loss of better corrected visual acuity
a reduced risk of losing visual quality, night time vision and sensitivity to contrasts
a greater ability to restore a better corrected visual acuity in case of functional complaints after an initial treatment.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove soft contact lenses.
Look for prescribed medicines: Dafalgan Codeine (a sedative), Predmycin P collyre (an anti-inflammatory), Voltaren or Aculare (a painkiller), Systane and Hyal-Drop / Hylogel (artificial tears solution).
Do not put on any mascara.
Contact the driver who will be taking you.
Arrive 30 minutes early or 1 hour early for customised treatment.
Do not put on any mascara, make-up or perfume.
1/2 hour before your appointment, take 1 tablet of Dafalgan Codeine. This medicine will relax you and may make you sleepy.
Bring with you to the clinic: Dafalgan, Voltaren / Aculare, Predmycin P collyre and Systane and Hyal-Drop / Hylogel (do not open the bottles).
The examination and operation last about 1 to 2 hours. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
Anaesthesia is carried out using 3 drops, just immediately before the operation.
The ophthalmologist will take care to explain everything to you: no surprises.
Your eye will be held open by an eyelid spreader, which will prevent you from blinking.
First of all, the ophthalmologist will place a suction ring on your eye. The suction will make a bit of noise and you will feel tension on your eyeball. During suction, sight disappears for a few moments.
Next the keratome will be installed on the suction ring and this will go above your eye, like a tiny miniature train. The “corneal flap” has been carried out, the keratome and ring will be undone.
The “flap” will be lifted and the laser is activated.
It is very important to continue to stare at the little red or green light in the operating microscope throughout the treatment. You will hear a crackling noise and this will be accompanied by a slight smell of burning. This is caused by the corneal tissue burning and is completely normal.
Lastly, your eye will be irrigated and the cornea’s “flap” will be put back in place and dried. The operation lasts about 10 minutes per eye. In case of bilateral treatment, the right eye will be treated first.
You will be given transparent protective shells that you will have to wear while you are sleeping, and this will be for a week after the operation.
After the effect of the anaesthetic, you may feel stinging. This sensation disappears after 2 to 3 hours.
During the first 3 weeks, in no case will you be allowed to rub your eyes.
If you have significant pain or any worries, contact your ophthalmologist.
You will have to apply drops according to the plan given below:
The day of the operation
Predmycine P collyre (an anti-inflammatory): 4 times a day during the week following the operation.
Voltaren / Aculare (a painkiller): up to 3 times a day, in case of a gritty or burning sensation.
From the next day, the following need to be added:
Systane: maximum 3 times a day
Hyal-Drop / Hylogel (artificial tears solution): as required, to be used up to 8 times a day, especially the first week after the operation. If your eyes still feel dry with Systane, you use Hyal-Drop / Hylogel. These drops are greasier and more viscous.
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
You will be functional right from the following morning. Vision will still not be perfect, essentially due to a loss of sensitivity to contrasts. Reading in particular may be difficult at the beginning.
Do not plan major or sporting activities over the days following the operation.
The first 2 weeks: do not use eye make-up.
The first 3 weeks: do not go swimming.
In the case of unilateral treatment, you are advised to have the lens in your glasses on the operated eye side removed, as this will no longer be suitable. The difference between the two eyes will now be fairly large, especially if you had a major correction (for example of more than -3 dioptres) and you will find it difficult to tolerate your glasses. Be careful when driving a car as your depth perception will not be good while the second eye has not been operated on.
You must schedule check-up appointments with your ophthalmologist on the first day after the operation. The final result will be assessed after +/- 6 weeks, a possible re-treatment will be planned at that time.
1st day
6th week
On request if worried.
The FemtoLASIK or “All-Laser LASIK” is a revolutionary technique in the field of refractive laser surgery. With FemtoLASIK, cutting the cornea is not mechanical (traditional LASIK), but is done using a femtosecond laser. Result: a minimal lesion for even quicker healing.
The latest development in LASIK is the FemtoLASIK. Traditional LASIK treatment cuts the cornea mechanically using a scalpel and a keratome driven by a motor. FemtoLASIK cuts the cornea using a femtosecond laser, via photodisruption. A very uniform cut is then obtained.
FemtoLASIK combines the benefits of traditional LASIK, like comfort and predictability, with the benefits of the femtosecond laser:
minimal lesion when cutting
quicker healing due to a uniform cut
very high precision
a greater stability of the result
Are you suffering from a major refractive deformation? Classical LASIK treatment is not a solution for you. In this respect, FemtoLASIK is a fantastic development. It enables people suffering from severe short-sightedness, astigmatism or far-sightedness to be treated.
The risk of complication with FemtoLASIK is even less than with LASIK. The surgical risks, inherent with any operation, are even more limited. Especially if the FemtoLASIK procedure is carried out by an experienced surgeon.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove soft contact lenses.
Look for prescribed medicines: Dafalgan Codeine (a sedative), Predmycin P collyre (an anti-inflammatory), Voltaren (a painkiller) or Aculare, Systane and Hyal-Drop / Hylogel (artificial tears solution) and linseed oil.
Do not put any mascara.
Contact the driver who will be taking you.
Arrive 30 minutes early or 1 hour early for customised treatment
Do not put any mascara, make-up or perfume on.
1/2 hour before your appointment, take 1 tablet of Dafalgan Codeine. This medicine will relax you and may make you sleepy.
Bring with you to the clinic: Dafalgan, Voltaren / Aculare, Predmycin P collyre and Systane and Hyal-Drop / Hylogel (do not open the bottles).
The examination and operation last about 1 to 2 hours. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
You will be given a transparent protective shell that you will have to wear while you are sleeping, and this will be for a week after the operation. After the effect of the anaesthetic, you may feel stinging. This sensation disappears after 2 to 3 hours.
During the first 3 weeks, in no case will you be allowed to rub your eyes.
If you have significant pain or any worries, contact your ophthalmologist.
You will have to apply drops according to the plan given below:
On the day of the operation:
Predmycine P collyre (an anti-inflammatory): 4 times a day during the week following the operation.
Voltaren (a painkiller) or Aculare: as required, in case of a gritty or burning sensation.
From the next day, the following need to be added:
Systane (artificial tears solution): to be used up to 3 times a day, especially the first week after the operation, you can also use Oxyal / Hyal-Drop which is more viscous if your eyes remain dry (if necessary once an hour).
Linseed oil: 2 capsules a day, 1 in the morning and 1 in the evening with meals.
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
You will be functional right from the following morning. Vision will still not be perfect, essentially due to a loss of sensitivity to contrasts. Reading in particular may be difficult at the beginning.
Do not plan major or sporting activities over the days following the operation.
The first 2 weeks: do not use eye make-up
The first 3 weeks: do not go swimming.
You must schedule check-up appointments with your ophthalmologist on the day after the operation. The final result will be assessed after +/- 6 weeks, a possible re-treatment will be planned at that time.
1st day
6th week
The operation is done as an outpatient and lasts 10 minutes. The patient receives a sedative before the operation, anaesthesia is done using drops. First of all, the epithelium is removed. The critical period during which the laser will act on the tissues and during which the patient must stare at the centre of the microscope, is less than one minute. With short-sightedness, the laser is going to flatten the surface of the central cornea. With far-sightedness, it removes a ring of tissue around the optical area, which then arches. The treatment is painless. Once the anaesthetic wears off, the eye that has been operated on will often be painful and weeping; the patient feels a gritty sensation. The epithelium takes 2 to 3 days before recovering the treated surface. To accelerate this epithelialisation and decrease the pain, a “dressing” contact lens is applied for 3 days. Anti-inflammatory drops and antibiotics will then be applied for a week.
In rare cases, an abnormal corneal scarring ("haze") may develop which may affect visual acuity and cause annoying reflections. This area can be retreated by laser but no sooner than 6 months after the initial surgery. In less than 1% of cases, the scar reforms, resists all rework and permanently affects vision.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove soft contact lenses.
Look for prescribed medicines: Dafalgan Codeine (a sedative), Trafloxal (an anti-inflammatory), Vexolone, Indocollyre (a painkiller), Systane and Oxyal / Hyal-Drop / Hylogel (artificial tears solution) and linseed oil.
Do not put any mascara.
Contact the driver who will be taking you.
1/2 hour before your appointment, take 1 tablet of Dafalgan Codeine. This medicine will relax you and may make you sleepy.
Do not put any mascara, make-up or perfume on.
Bring with you to the clinic: Indocollyre, Trafloxal, Vexolone, Systane and Oxyal / Hyal-Drop (do not open the bottles).
The examination and operation last +/- 1 to 2 hours. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
Anaesthesia is carried out using 3 drops, just immediately before the operation.
The ophthalmologist will take care to explain everything to you: no surprises.
Your eye will be held open by an eyelid spreader, which will prevent you from blinking.
First of all the ophthalmologist will place a metal ring on your eye that he will then fill with an alcohol solution. After a few seconds, the alcohol solution will be absorbed. During PRK treatment, the epithelium is removed. The cornea is rinsed to eliminate impurities and dried. During LASEK treatment, the epithelium is rolled back and replaced after the operation. Next, the laser is activated.
It is very important to continue to stare at the little red or green light in the operating microscope throughout the treatment. You will hear a crackling noise and this will be accompanied by a slight smell of burning. This is caused by the corneal tissue burning and is completely normal.
Lastly, your eye will be irrigated and a contact lens will be placed on your eye.
The entire operation lasts about 10 minutes per eye. In case of bilateral treatment, the right eye will be treated first.
You will have to apply drops according to the plan given below:
The day of the operation:
Trafloxal (an anti-inflammatory): 4 times a day during the week following the operation.
Vexolone: to be used from re-epithelisation (3 days after the operation): 3 times a day for a week, twice a day for a week, once a day for 1 week.
Indocollyre (a painkiller): as required, in case of a gritty or burning sensation.
From the next day, the following need to be added:
Systane (artificial tears solution): to be used up to 3 times a day, especially the first week after the operation, you must also use Oxyal / Hyal-Drop up to 8 times a day which is more viscous.
Linseed oil: 2 capsules a day, 1 in the morning and 1 in the evening at meal time.
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
The contact lens will remain on your eye for 3 days. During this time, you will still not be functional: vision remains blurred, the eye may be painful and red. After 3 days, the lens will be removed during a post-operative check-up, and vision will slowly improve. The pain and redness will subside. Vision becomes clearer in about one week, but vision quality will still continue to improve for 1 to 2 months after the operation.
If you suffer significant pain or you are worried, do not hesitate to contact your ophthalmologist.
Do not plan major or sporting activities over the days following the operation.
The first 2 weeks: do not use make-up.
The first 3 weeks: do not go swimming.
In the case of unilateral treatment, you are advised to have the glass in your glasses on the operated eye side removed, as this will no longer be suitable. The difference between the two eyes will now be fairly large, especially is you had a major correction (for example of more than -3 dioptres) and you will find it difficult to tolerate your glasses. Be careful when driving a car as your depth perception will not be good while the second eye has not been operated on.
You must schedule check-up appointments with your ophthalmologist on the third day after the operation, until the time the wound has healed. The final result will be assessed after +/- 6 weeks, a possible rework will be planned at that time.
3rd day
10th day
6th week
LASEK can be used in patients where LASIK is contraindicated, often due to a cornea that is too thin.
The operation is done as an outpatient under anaesthesia by drops and lasts 15 minutes. This technique can be considered as a modernised PRK. In an initial phase, an epithelial flap is removed by using an alcohol solution and is rolled back. Next, the corneal tissues are vaporised by the Excimer Laser that sculpts the outer surface of the cornea in order to modify its refractive strength. The epithelial flap is put back in place under a “dressing” contact lens.
The results are comparable to those of LASIK, but the re-establishment of the ocular surface is slower. Functional recovery of visual acuity occurs after 3 to 5 days. Visual acuity is stabilised after 3 weeks to several months. The benefit compared to PKR is that there is less pain after the operation.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove soft contact lenses.
Look for prescribed medicines: Dafalgan Codeine (a sedative), Trafloxal (an anti-inflammatory), Vexolone, Indocollyre (a painkiller), Systane and Oxyal / Hyal-Drop / Hylogel (artificial tears solution) and linseed oil.
Do not put any mascara.
Contact the driver who will be taking you.
1/2 hour before your appointment, take 1 tablet of Dafalgan Codeine. This medicine will relax you and may make you sleepy.
Do not put any mascara, make-up or perfume on.
Bring with you to the clinic: Indocollyre, Trafloxal, Vexolone, Systane and Oxyal / Hyal-Drop (do not open the bottles).
The examination and operation last +/- 1 to 2 hours. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
Anaesthesia is carried out using 3 drops, just immediately before the operation.
The ophthalmologist will take care to explain everything to you: no surprises.
Your eye will be held open by an eyelid spreader, which will prevent you from blinking.
First of all the ophthalmologist will place a metal ring on your eye that he will then fill with an alcohol solution. After a few seconds, the alcohol solution will be absorbed. During PRK treatment, the epithelium is removed. The cornea is rinsed to eliminate impurities and dried. During LASEK treatment, the epithelium is rolled back and replaced after the operation. Next, the laser is activated.
It is very important to continue to stare at the little red or green light in the operating microscope throughout the treatment. You will hear a crackling noise and this will be accompanied by a slight smell of burning. This is caused by the corneal tissue burning and is completely normal.
Lastly, your eye will be irrigated and a contact lens will be placed on your eye.
The entire operation lasts about 10 minutes per eye. In case of bilateral treatment, the right eye will be treated first.
You will have to apply drops according to the plan given below:
The day of the operation:
Trafloxal (an anti-inflammatory): 4 times a day during the week following the operation.
Vexolone: to be used from re-epithelisation (3 days after the operation): 3 times a day for a week, twice a day for a week, once a day for 1 week.
Indocollyre (a painkiller): as required, in case of a gritty or burning sensation.
From the next day, the following need to be added:
Systane (artificial tears solution): to be used up to 3 times a day, especially the first week after the operation, you must also use Oxyal / Hyal-Drop up to 8 times a day which is more viscous.
Linseed oil: 2 capsules a day, 1 in the morning and 1 in the evening at meal time.
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
The contact lens will remain on your eye for 3 days. During this time, you will still not be functional: vision remains blurred, the eye may be painful and red. After 3 days, the lens will be removed during a post-operative check-up, and vision will slowly improve. The pain and redness will subside. Vision becomes clearer in about one week, but vision quality will still continue to improve for 1 to 2 months after the operation.
If you suffer significant pain or you are worried, do not hesitate to contact your ophthalmologist.
Do not plan major or sporting activities over the days following the operation.
The first 2 weeks: do not use make-up.
The first 3 weeks: do not go swimming.
In the case of unilateral treatment, you are advised to have the glass in your glasses on the operated eye side removed, as this will no longer be suitable. The difference between the two eyes will now be fairly large, especially is you had a major correction (for example of more than -3 dioptres) and you will find it difficult to tolerate your glasses. Be careful when driving a car as your depth perception will not be good while the second eye has not been operated on.
You must schedule check-up appointments with your ophthalmologist on the third day after the operation, until the time the wound has healed. The final result will be assessed after +/- 6 weeks, a possible rework will be planned at that time.
3rd day
10th day
6th week
EPI-LASIK can be considered as the renewed PRK technique (similar to LASEK) and can be used on people who are not suitable for LASIK, due to a cornea that is too thin.
The operation is done as an outpatient using anaesthetising drops and lasts 15 minutes. During EPI-LASIK, the epithelium is not removed using alcohol but mechanically, using a keratome. The epithelial tissue is vaporised, using the excimer laser in order to modify the outer surface and consequently the cornea’s refractive strength. Next, the epithelial flap is put back in place under a “dressing” contact lens
The results are comparable to those of LASIK, but the healing process of the ocular surface is slower. After 3 to 5 days, the patient recovers a functional visual acuity and after 3 weeks to several months, a stabilised visual acuity. The benefit compared to PKR is that you feel less pain after the operation.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove soft contact lenses.
Look for prescribed medicines: Dafalgan Codeine (a sedative), Trafloxal (an anti-inflammatory), Vexolone, Indocollyre (a painkiller), Systane and Oxyal / Hyal-Drop / Hylogel (artificial tears solution) and linseed oil.
Do not put any mascara.
Contact the driver who will be taking you.
1/2 hour before your appointment, take 1 tablet of Dafalgan Codeine. This medicine will relax you and may make you sleepy.
Do not put any mascara, make-up or perfume on.
Bring with you to the clinic: Indocollyre, Trafloxal, Vexolone, Systane and Oxyal / Hyal-Drop (do not open the bottles).
The examination and operation last +/- 1 to 2 hours. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
Anaesthesia is carried out using 3 drops, just immediately before the operation.
The ophthalmologist will take care to explain everything to you: no surprises.
Your eye will be held open by an eyelid spreader, which will prevent you from blinking.
First of all the ophthalmologist will place a metal ring on your eye that he will then fill with an alcohol solution. After a few seconds, the alcohol solution will be absorbed. During PRK treatment, the epithelium is removed. The cornea is rinsed to eliminate impurities and dried. During LASEK treatment, the epithelium is rolled back and replaced after the operation. Next, the laser is activated.
It is very important to continue to stare at the little red or green light in the operating microscope throughout the treatment. You will hear a crackling noise and this will be accompanied by a slight smell of burning. This is caused by the corneal tissue burning and is completely normal.
Lastly, your eye will be irrigated and a contact lens will be placed on your eye.
The entire operation lasts about 10 minutes per eye. In case of bilateral treatment, the right eye will be treated first.
You will have to apply drops according to the plan given below:
The day of the operation:
Trafloxal (an anti-inflammatory): 4 times a day during the week following the operation.
Vexolone: to be used from re-epithelisation (3 days after the operation): 3 times a day for a week, twice a day for a week, once a day for 1 week.
Indocollyre (a painkiller): as required, in case of a gritty or burning sensation.
From the next day, the following need to be added:
Systane (artificial tears solution): to be used up to 3 times a day, especially the first week after the operation, you must also use Oxyal / Hyal-Drop up to 8 times a day which is more viscous.
Linseed oil: 2 capsules a day, 1 in the morning and 1 in the evening at meal time.
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
The contact lens will remain on your eye for 3 days. During this time, you will still not be functional: vision remains blurred, the eye may be painful and red. After 3 days, the lens will be removed during a post-operative check-up, and vision will slowly improve. The pain and redness will subside. Vision becomes clearer in about one week, but vision quality will still continue to improve for 1 to 2 months after the operation.
If you suffer significant pain or you are worried, do not hesitate to contact your ophthalmologist.
Do not plan major or sporting activities over the days following the operation.
The first 2 weeks: do not use make-up.
The first 3 weeks: do not go swimming.
In the case of unilateral treatment, you are advised to have the glass in your glasses on the operated eye side removed, as this will no longer be suitable. The difference between the two eyes will now be fairly large, especially is you had a major correction (for example of more than -3 dioptres) and you will find it difficult to tolerate your glasses. Be careful when driving a car as your depth perception will not be good while the second eye has not been operated on.
You must schedule check-up appointments with your ophthalmologist on the third day after the operation, until the time the wound has healed. The final result will be assessed after +/- 6 weeks, a possible rework will be planned at that time.
3rd day
10th day
6th week
Severe short-sightedness (from -8 to -22 dioptres) and far-sightedness (from +4 to +12 dioptres) can also be treated. Even higher refractive errors can be corrected by combining the use of phakic implants with LASIK (Bi-optics). Since 2003, there are also implants in which pre-existing astigmatism is incorporated in the lens optics (torical implants).
This is an intraocular operation, contrary to LASIK where work is only done on the eye surface. Surgery is done under local anaesthetic, in the form of a local injection or by drops. An Artisan® implant in PMMA (polymethyl methacrylate) is inserted into the anterior chamber of the eye by a small incision on the upper edge of the cornea. The implant is attached to the iris by means of 2 clips. The incision is closed by 5 separate sutures. This operation lasts 20 minutes. Since 2005, this implant is also available in a soft silicone (Artiflex®) that can be inserted by a 3.2 mm incision that no longer has to be sutured. Short-sightedness up to -14 dioptres can be treated with this implant.
If you wear hard or semi-hard contact lenses, they must be removed at least two weeks before the operation. This is particularly necessary if you have been wearing contact lenses for a long time.
Remove the soft contact lens (from the eye that will be treated). If treatment on one eye only is indicated you only have to remove the contact lens from the eye that will be treated.
You can wear your contact lens until the day before the operation
Look for prescribed medicines: Dafalgan Codeine (a sedative), Isoptocarpine eye drops (in order to have a small pupil before the operation), Tobradex eye drops (anti-inflammatory), Tobrex eye drops (see below) and Diamox tablets in tablet form (to avoid increased pressure).
3 days before the operation, 3 times a day, instil 1 drop of Tobrex in the eye that will be treated.
Do not put on mascara.
Contact the driver who will accompany you.
Arrive 30 minutes early.
Do not put on mascara, make-up or perfume
1 hour before the operation: every 15 minutes instil 1 drop of Isoptocarpine in the eye to be treated.
Half an hour before your appointment (when you arrive): take 1 Dafalgan Codeine tablet. This drug will relax you and may make your sleepy.
Bring with you to the clinic: Tobradex drops (do not open the bottle) and Diamox tablets.
The operation and preparation last +/- 1 hour. If there was to be a delay caused by previous treatments, you will need to take waiting time into account.
Anaesthesia is carried out using an injection in the cheek (only if an Artisan implant) and 2 drops in the eye just before the operation.
The ophthalmologist will take care to explain everything to you: no surprises.
Your eye will be held open by a spacer, which will prevent you from blinking.
There will be no pain.
The operation lasts about 25 minutes.
Your eye will be covered with a compress, which you must keep on for at least 4 hours after the operation (sometimes until the next day if the operation was in the evening; you can take it off when you wake up).
Immediately after the operation take one Diamox tablet and another one before going to bed and when waking up the following day.
The transparent protective shell must be worn every night for a week after the operation.
Drops will have to be applied according to the plan below from the day after the operation.
Tobradex eye drops:
For the first 3 weeks: 1 drop 4 times a day
4th week: 1 drop 3 times a day
5th week: 1 drop twice a day
6th week: 1 drop once a day
The technique for instilling drops is very important: do not touch the eyeball. Pull the lower eyelid down, while looking upwards. Apply the drop and close the eye.
You will be functional by the following morning. Vision will still not be perfect. After the first operation you will be especially bothered by the major difference between the two eyes.
In case of significant pain or worry, contact your ophthalmologist.
Do not plan major or sporting activities over the days following the operation.
During the first 3 weeks, in no case will you be able to rub your eyes.
The first 2 weeks: do not use make-up.
The first 3 weeks: do not go swimming.
Avoid dusty environments.
You must schedule check-up appointments with your ophthalmologist on the 1st and 3rd day after the operation, until the wound heals. The final result will be assessed after +/- 6 weeks.
1st day
3rd day
10th day
6th week
In a third of patients, the capsule may become opaque months or even years after the operation. This phenomenon is called a secondary cataract. The treatment is uncomplicated and is done using a YAG laser: an opening is made in the damaged capsule (capsulotomy), which enables vision to be restored by the following day.
This operation involves the same rare risks as cataract surgery: the most serious complication would be an intraocular infection (1/2500).
The patient’s general practitioner will be consulted to check whether there are any contraindications for operating under local anaesthetic. In most cases an electrocardiogram and a routine blood test are carried out, if this has not been done during the last six months.
In case of doubt, the general practitioner may send the patient to a cardiologist for additional examinations.
These examinations must be done at least one week before the planned date for the operation.
The results of these examinations must be sent to us by mail or by fax.
The appointment for your operation must be confirmed with Brussels Eye Doctors (02 / 741.69.99).
A prescription for the drops will be given to the patient. These must be obtained from your pharmacy.
Tobrex (an antibiotic) and Indocollyre (an anti-inflammatory): these drops will be applied in the eye to be operated on for the 3 days preceding the operation and three times a day, with an interval of 5 minutes between each type of drops. Tobradex (to be used post-operatively).
If, at the time of the operation, you are following a particular treatment prescribed by your general practitioner or specialist, this treatment must be continued even on the day of the operation. This applies to anticoagulants such as Sintrom, Aspirin, etc. if the operation is done under topical anaesthesia.
either using drops that will be instilled every 15 minutes, 1 hour before the operation
or using a tablet that is inserted in the eye to be operated on 1 hour before the operation. This tablet will be put in place by the Eye-Clinic’s nursing staff once the patient has registered.
In some cases dilation of the pupil will be obtained by a product that will be applied in the operating theatre at the start of the operation.
the patient will come to the admission desk of the Park Léopold Clinic’s eye clinic (located on the clinic’s ground floor) half an hour before the appointment set for the operation.
the patient will be able to leave the hospital about 15 minutes after the surgical operation and will not have to wear a protective shell.
a protective shell will be given to the patient after the operation, it will be worn every night for one week.
As soon as he returns home, the patient will apply the drops in the following way:
Tobradex: one drop 4 times a day for three weeks, the dose will progressively be reduced
Indocollyre: one drop 3 times a day until the bottle is empty
One to two check-ups will be carried out in the week following the operation to check if everything has gone well and to detect any signs of infection.
The operations are also done at Brussels Eye Doctors. The dates and times of these operations are set during the pre-operative examination.
the patient will come to the clinic half an hour before the appointment set for the operation.
all the other instructions mentioned above are applicable.
Hospitalisation may be envisaged in special circumstances. In this case, the patient is admitted the afternoon before the operation and leaves hospital two days later. Two check-ups will be carried out during these two days.
As soon as the operation is ended, you will be able to drink and eat.
Sometimes there may be slight pain or irritation. All you need to do then is take an analgesic like Perdolan or Dafalgan. In case of abnormal pain or worry contact Dr. Vryghem at the Parc Léopold clinic or Brussels Eye Doctors during office hours or on his mobile or private telephone number outside office hours.
During the first few days after the operation, it is highly advisable to avoid any direct trauma on the eye, not to exert yourself (e.g. lifting weights) and to avoid dusty environments.
The patient will apply drops for 6 weeks:
Tobradex one drop 4 times a day for 3 weeks, after which the treatment is gradually reduced:
one drop 3 times a day for 1 week
one drop twice a day for 1 week
one drop once a day for 1 week
Indocollyre one drop 3 times a day until the bottle is empty.
The patient’s vision and any discomfort will rapidly improve.
A final check-up is carried out six weeks after the operation, at which time final glasses will be prescribed. In general these are only reading glasses.
1st day
3rd day
10th day
6th week