Second opinion

Have you already
had eye surgery?

Previous eye surgery — refractive laser, radial keratotomy or other — permanently changes the geometry of the eye. This does not close every door, but it calls for a specific assessment before any new procedure.

Why a different approach

A surgical history changes
the calculation parameters.

Implant calculation formulas, the decision thresholds for a new laser correction and the interpretation of corneal topography all rely on reference values established for eyes that have never been operated on. After previous surgery, these values are altered — sometimes irreversibly.

Care is not impossible; it is different. It requires additional examinations, adapted calculation formulas and specific experience of these situations.

Why the implant calculation changes after a corneal laser Three views. On an untreated cornea, instruments measure the front surface and infer the total power, assuming a fixed ratio between the two surfaces. After a laser, the front surface is flattened while the back surface is unchanged: that ratio no longer holds and the corneal power is overestimated. Once the implant is in place, an underpowered lens leaves the focus behind the retina. After a laser, the implant calculation changes The front surface of the cornea has changed, the back surface has not — and instruments assume the two go together. UNTREATED CORNEA ratio holds front surface back surface the measurement is reliable Instruments measure the front surface andinfer the total power, assuming a fixedratio between the two surfaces. AFTER A CORNEAL LASER ratio broken front surface flattened back surface unchanged the measurement must be corrected The laser flattens the front surface andleaves the back one intact. The assumedratio is gone, and the power is overestimated. AFTER THE IMPLANT IS IN PLACE distance vision stays blurred An overestimated power leads to anunderpowered implant: distance visionstays blurred and needs correcting again. retina focus This is neither a complication of the laser nor an error of the instrument: it is an assumption that no longer holds.It can be corrected, provided the measurements from before the laser and the treated correction are available.Keep those documents: twenty or thirty years later, they are worth as much as the examination of the day.
Why the measured keratometry is no longer the right one
Your situation

Recognise your history.

Each surgical history has its own technical constraints. Identify the situation that matches yours below to access the relevant information.

Situation 01

Laser surgery
several years ago

You had LASIK, PRK or another laser technique to correct your myopia, hyperopia or astigmatism. You are now developing a cataract or would like a new correction.

  • LASIK
  • transPRK / PRK
  • KLEx
Understand the issues →
Situation 02

Radial keratotomy
before the 2000s

Radial keratotomy (RK) is a refractive surgical technique performed before the laser era. The corneal incisions it leaves call for particular precautions in any later implant calculation.

  • Radial incisions
  • Irregular cornea
  • Specific calculation
Understand the issues →
Situation 03

Enhancement after
laser surgery

Your visual result has declined after refractive laser surgery — a residual error from the outset, gradual regression or presbyopia that has appeared with age. Is re-treating the cornea possible, and is it the best option?

  • Residual error
  • Regression
  • Presbyopia
Understand the options →
Situation 04

Unsatisfactory vision
after lens surgery

Your vision remains blurred, light halos persist, or the result does not meet your expectations after cataract surgery or lens exchange. Understanding the source of the problem before considering any further step.

  • Residual refractive error
  • Implant intolerance
  • Second opinion
Understand the options →
Situation 05

A phakic implant
fitted twenty years ago

An implant was placed in front of your iris to correct high myopia, between the late 1990s and the early 2010s. The corneal endothelium is then monitored for life, and the question of removal may arise.

  • Artisan / Verisyse
  • Artiflex
  • Endothelium
Understand the issues →
The approach

What a
second-opinion consultation involves.

A second opinion does not call your previous care into question. It means reassessing the situation from the current data of your eye — topography, biometry, biomechanical analysis — taking your surgical history and your present visual goal into account.

This consultation leads to clear information about the available options, the conditions for carrying them out and their limits. Depending on the characteristics of your eye, some procedures may be offered; others may be contraindicated.

Consultations take place at Clinique Saint-Pierre Ottignies (CSPO), Walloon Brabant.

Book an appointment at CSPO →

To better understand how a consultation unfolds

The patient journey — from consultation to follow-up →

Irregular cornea after a previous procedure (particularly after RK)

PTK — corneal surface →