You have never consulted for refractive surgery. You want to first understand whether it is a realistic option before going further. This consultation is shorter, without pupil dilation. You can come alone and drive away afterwards. It allows a first overview, an evaluation of your general profile and a decision on whether a complete exam is relevant.
This is the stage that determines everything. It includes pupil dilation with cycloplegic drops, which temporarily paralyse the ciliary muscle to measure the real visual defect, without muscular compensation. This is essential for the precision of the calculations, particularly for hyperopia and complex corrections.
Arrange for someone to accompany you or a taxi to go home. Pupil dilation makes driving impossible for two to three hours. Avoid eye make-up on the day of the exam. Allow one hour and don't be in a rush.
If you wear soft contact lenses: stop at least 48 hours before. If you wear rigid lenses: stop at least one week before. Contact lenses transiently modify corneal shape and would distort the calculations.[1]
Three-dimensional mapping of the corneal surface. It measures curvatures at thousands of points and detects irregularities invisible to standard examination, particularly subclinical forms of keratoconus that formally contraindicate laser. It is the most important test for the safety of the surgical decision.[2]
Measurement of corneal thickness at all its points. It determines whether the cornea has sufficient tissue reserve for safe laser and, if so, which technique is appropriate.
Analysis of complex optical defects of the eye, beyond the simple myopia or hyperopia measured by the optician. It guides the laser treatment profile for a correction that goes further than standard correction.
Measurement of the real visual defect after pupil dilation. Without this step, the eye partially compensates, especially in hyperopia, and distorts the calculations. This measurement sometimes reveals a defect much greater than what the optician had measured.[3]
Measurement of the axial length of the eye and dimensions of the anterior chamber. Essential for calculating the power of ICL implants and for evaluating the retinal risk in high myopes.
Screening for dry eye that may change the choice of technique or require prior treatment. Dryness undetected before Femto-LASIK can compromise the result and postoperative comfort.
Examination of the peripheral retina, particularly important for high myopes, in whom elongation of the eyeball can create retinal weaknesses independent of any surgical decision.[4]
At the end of the exam, I present my conclusions face to face. Not a report sent by post.
If you are a surgical candidate. I explain which technique is suited to your profile and why. I present what you can realistically expect from the result. I answer all your questions. If you decide to go ahead, we plan the procedure together.
If a contraindication exists. I explain it clearly: its nature, what it means for your follow-up, and what alternatives can be considered. An exam that concludes with a contraindication is not a failed exam. It is an exam that did exactly what it exists for.
In every case. You leave with a clear medical answer, based on your real data, given by the surgeon who would operate on you if you decided to go ahead. And I never pressure you to decide that day. The decision is yours.
References
At the end of the exam, you leave with a precise answer on your eligibility, an explanation of the techniques compatible with your corneal and refractive profile, and a first estimate of the cost of the procedure. If you are eligible and wish to proceed, the procedure date is scheduled during this same consultation.
If your profile is not eligible for laser surgery, other options are evaluated: ICL implants for corneas contraindicated for laser, PRELEX for presbyopic profiles, or simple monitoring if no procedure is indicated at this stage.
If you wear contact lenses, stopping them before the exam is essential: at least 48 hours for soft lenses, one week for rigid or toric lenses. This precaution is essential so that corneal topography reflects the real shape of your cornea.
Plan for someone to accompany you: pupil dilation (needed for some tests) makes driving impossible for two to three hours after the exam. No need to fast.
The complete preoperative exam lasts about one hour. It brings together all the tests needed for the surgical decision and the precise calculation of treatment parameters. The results are analysed during a discussion with Dr Serdal Sanak, who explains in detail what they mean and which options are suited to your situation.