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Refractive error

Myopia surgery in Brussels

The essentials about myopia

  • Definition : eye too long, image formed in front of the retina. Blurred distance vision, sharp near vision.
  • Prevalence : 23.5% across Europe overall, 47% among adults aged 25-29 (Williams 2015).
  • Surgical solutions : Femto-LASIK, PRK up to -8 D, ICL implants beyond.
  • Eligibility criteria : correction stable for 2 years, absence of keratoconus.
  • Point of vigilance : severe myopia beyond -6 D → annual retinal follow-up recommended.
  • Indicative price : 1700-2250 € per eye for laser, 2700-3500 € per eye for ICL.

On this page

  1. What is myopia exactly?
  2. What are the solutions for myopia?
  3. The grey zone between −6 and −8 D
  4. What patients often ask
Understanding

What is myopia exactly?

Myopia is a refractive error of the eye. A myopic eye is too long relative to its optical power: light converges in front of the retina rather than on it. Distant objects appear blurry; near vision remains sharp.

It is measured in negative dioptres on your prescription. It usually appears in childhood or adolescence and stabilises, in most cases, between 18 and 25 years of age.[1]

Myopic eye The eye is too long: the image of a distant object forms in front of the retina. too early lens blurred image

The myopic eye. The globe is too long for the power of its cornea. Rays coming from a distance converge before the retina, then separate again: distance vision is blurred.

Corrected myopic eye After correction, the image of a distant object forms on the retina. corrective lens lens sharp image

After correction. A concave lens, or laser reshaping of the cornea, moves the convergence point further back. The image then forms exactly on the retina.

Why does one become myopic?

Myopia is largely hereditary. When both parents are myopic, the risk for the child is multiplied by six compared with non-myopic parents.[2] Environmental factors also play a role: prolonged near work, screen exposure and lack of natural light are associated with faster progression. A cluster-randomised trial in Shanghai on 6,295 children showed that adding 40 minutes of outdoor activity per school day reduced the incidence of myopia by 23% over 3 years (30.4% versus 39.5% in the control group).[3]

Impact on daily life

Dependence on glasses or contact lenses shapes many activities: sport, night driving, working on screens in mixed environments. Driving without correction is prohibited beyond a certain threshold of visual deficit.[4] Halos and reduced night contrast are common in uncorrected myopes.

Not all myopia is the same

Low myopia · 0.25 to 3 D
Mainly bothersome at distance. Many patients function without correction indoors.

Moderate myopia · 3 to 6 D
Daily dependence on optical correction. Quality of life significantly reduced as soon as the correction is removed.

High myopia · beyond 6 D
Very blurry vision without correction from just a few centimetres away. The elongation of the eyeball generates retinal tensions which justify regular monitoring with fundus examination, regardless of any surgical decision.[5]

High myopia and retinal monitoringBeyond 6 D, an annual fundus examination is recommended by the French Society of Ophthalmology, whether surgery is considered or not.[5]

References

  1. Gaucher D, Leveziel N, et al. Les myopies. Second report of the French Society of Ophthalmology. Paris: Elsevier Masson; 2019.
  2. Mutti DO, et al. Parental myopia, near work, school achievement, and children's refractive error. Invest Ophthalmol Vis Sci. 2002;43(12):3633-3640.
  3. He M, et al. Effect of time spent outdoors at school on the development of myopia among children in China. JAMA. 2015;314(11):1142-1148.
  4. Belgian Royal Decree of 23 March 1998 on the driving licence. Minimum visual conditions Annex 6.
  5. Gaucher D, Leveziel N, et al. Les myopies. Second report of the French Society of Ophthalmology. Paris: Elsevier Masson; 2019.
Surgical options

What are the solutions for myopia?

Three techniques today provide durable correction of myopia. The choice depends on your correction, your corneal thickness and your expectations.

Femto-LASIK
The most performed technique. Results visible the next day. Indicated up to approximately −8 D depending on the corneal profile.
PRK
Surface technique, without corneal flap. Ideal for thin corneas or regulated professions. Results equivalent to Femto-LASIK in the long term.
ICL implants
For high myopia or corneas contraindicated for laser. No corneal ablation. Often superior optical quality for high corrections.
PRK vs Femto-LASIK
Hesitating between the two laser techniques? Compare their indications, advantages and recovery.
High myopia

The grey zone between −6 and −8 D

Between −6 and −8 dioptres, the decision between laser and ICL implants is not automatic. It is precisely in this range that the preoperative exam is most decisive.

Residual corneal thickness, topography and anterior chamber are the parameters that guide the choice. Two patients with the same correction can have radically different indications.

Beyond −8 D, ICL implants are in the vast majority of cases the reference solution: they make it possible to correct myopia that laser cannot treat safely.

The only way to know which technique is suited to your myopia is a complete exam. In one hour, I have all the parameters to give you a precise answer.

A preoperative exam determines precisely which technique is suited to your profile and whether surgery is an option for you. The first consultation is by appointment.

All about the preoperative exam
Related pages

Learn more

Femto-LASIK
The reference laser technique to correct myopia up to 8 dioptres.
PRK
The surface laser technique, for thin corneas or contact sports.
ICL implants
For high myopia or corneas contraindicated for laser.
Preoperative exam
Topography, pachymetry, fundus examination: the tests that determine your eligibility.
Frequently asked questions

What patients often ask

Can high myopia beyond 8 or 10 dioptres be operated on?

Yes, but not always with laser. Beyond 6 to 8 dioptres depending on corneal thickness, ICL implants are often the best option: they correct up to 18 dioptres without touching the cornea.

Can myopia come back after surgery?

A slight regression is possible, especially for high myopia. It is usually minimal and can be treated with a laser enhancement if needed.

Do I need to stop wearing contact lenses before the preoperative exam?

Yes. Soft contact lenses must be removed at least 48 hours before the exam. For rigid lenses, you must stop wearing them for at least one week.

Does high myopia increase the retinal risk?

Yes. Beyond 6 dioptres, an annual retinal check-up is recommended, independently of any surgical decision.

Can myopia worsen after age 25? In most cases, myopia stabilises between 20 and 25 years of age. A correction stable for at least two years is required before any refractive surgery. If the correction is still evolving, the procedure is postponed until stabilisation.

Can high myopia be operated on? Laser myopia surgery (Femto-LASIK, PRK) effectively corrects myopia up to −8 to −10 dioptres depending on corneal thickness. Beyond that, or when the cornea is too thin, ICL implants are the alternative of choice: they leave corneal tissue intact and correct myopia up to −18 dioptres.

Does myopia come back after laser surgery? No, unless the correction had not yet stabilised at the time of the procedure. That is why refractive stability is an essential eligibility criterion. On the other hand, the appearance of presbyopia after age 40 is an independent process that laser does not prevent.

Myopia is a very common refractive error that can be durably corrected by refractive surgery. The choice between Femto-LASIK, PRK and ICL implants depends on corneal thickness, the degree of myopia and lifestyle. The initial consultation allows the technique best suited to your profile to be identified in a single visit.

Dr Serdal Sanak, ophthalmic surgeon
Author of this page
Dr Serdal Sanak
Ophthalmic surgeon · Refractive and cataract surgery
CHIREC Hôpital Delta, Brussels
Graduated from the ULB, trained at CHU de Liège and CHIREC. European Diploma in Ophthalmology (FEBO). Refractive and cataract surgery make up the bulk of my operating activity, with procedures every week at CHIREC Delta. Dual specialisation: corneal laser surgery (Femto-LASIK, PRK) and intraocular surgery (ICL, PRELEX, cataract). Consultations in French, Dutch, English, Turkish, Kurdish, Persian and Italian.
Member: ESCRS · SBO · SFO · SAFIR
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