Patient journey

From the first consultation
to long-term follow-up

Refractive surgery does not begin in the operating theatre. It begins with a thorough assessment, continues with precise postoperative care, and is set within a structured follow-up. Here is what to expect, step by step.

  1. Step 1

    Preparation

    Stopping contact lenses, arranging transport

  2. Step 2

    Preoperative assessment

    Complete examination, about an hour, surgical decision

  3. Step 3

    The procedure

    ≈ 20 minutes, under topical (eye-drop) anaesthesia

  4. Step 4

    Postoperative course

    Eye drops, restrictions, visual recovery

  5. Step 5

    Follow-up

    Consultations included up to 3 months after surgery

Step 1

Before the consultation

What you need to do before coming

1 week

Soft contact lenses

Stop wearing soft contact lenses at least one week before your appointment. Contact lenses change the shape of the cornea: a topography performed too soon after removal can produce incorrect measurements.

1 month

Rigid lenses

Stop wearing rigid or semi-rigid lenses at least one month before the consultation. These lenses exert a more persistent pressure on the cornea and require a longer stabilisation period.

!

Arrange for someone to accompany you

Mydriatic eye drops will be instilled during the assessment to dilate your pupils. Your vision will remain blurred until the next day: you will not be able to drive. Arrange your return journey accordingly.

Step 2

The preoperative assessment

About an hour — three complementary evaluations

The preoperative assessment is the step that determines everything that follows: it establishes whether surgery is feasible, which technique is indicated, and which parameters will be used to calibrate the laser or calculate the implant. No surgical decision precedes this examination.

What the pre-operative assessment measures Cross-section of the whole eye with five measurements marked. Corneal tomography analyses the front and back surfaces of the cornea and its thickness. Corneal biomechanics assesses how the cornea resists deformation. Specular microscopy counts the cells on the inner surface of the cornea. Ocular biometry measures the length of the eye, the corneal curvature and the depth of the anterior chamber. Retinal tomography analyses the layers of the macula. What the assessment measures Five examinations, five different pieces of information: it is how they fit together that decides. length of the eye lens macula 1 Corneal tomography front and back surfaces, thickness 2 Corneal biomechanics resistance to deformation 3 Specular microscopy density of the cells on the inner surface of the cornea 4 Ocular biometry length of the eye, corneal curvature, depth of the anterior chamber 5 Retinal tomography layers of the macula and the optic nerve No one of these examinations replaces another: each looks at a different structure, and it is how they fit together that sayswhether a technique suits your eye — and which one. It is also why the assessment takes time and cannot be rushed.
What the pre-operative assessment measures
01

Orthoptic evaluation

A first refraction examination is performed without eye drops, under natural viewing conditions. This step assesses the functioning of the visual nervous system: stereopsis (3D vision), ocular dominance, balance of the visual axes. It allows the detection of a latent strabismus or an amblyopia that would change the correction goals.

02

Imaging evaluation

Several measuring devices produce a precise map of your eye. These data are essential for surgical planning.

  • Corneal tomography
    Maps the thickness and curvature of the cornea across its entire surface. Detects irregularities, thinning and shapes suggestive of keratoconus, which contraindicate laser surgery.
  • Corneal biomechanics
    Measures how the cornea deforms then recovers its shape under a calibrated air pulse. This assessment of corneal strength and elasticity complements the tomography: it helps identify more fragile corneas and refine the indication between surface surgery and other techniques.
  • Specular microscopy
    Measures the density of the corneal endothelial cells. These cells do not regenerate; their density determines certain indications, particularly for phakic implants.
  • Ocular biometry
    Measures the axial length of the eye and the distances between the ocular structures. Used to calculate the power of intraocular lenses.
  • Retinal tomography
    Produces microscopic images of the macula and optic nerve to make sure no disease of the retina compromises the visual prognosis.
03

Medical evaluation

After instilling a cycloplegic eye drop (cyclopentolate 1%), which temporarily paralyses accommodation and allows a precise objective refraction, the surgeon performs:

  • A history of ocular and general medical background
  • A discussion of professional and sporting activities and visual expectations
  • Slit-lamp examination: anterior segment, cornea, lens
  • Dilated fundus examination: retina, macula, optic nerve
  • Refraction under cycloplegia

At the end of this assessment, you receive clear information on feasibility, the recommended technique and any alternatives. If no surgery is indicated, you will be told so explicitly.

Step 3

The procedure

≈ 20 minutes — topical (eye-drop) anaesthesia

How it unfolds

  1. 1
    Settling in — You lie down on the operating table. Anaesthetic eye drops are instilled. The procedure is usually painless thanks to the anaesthetic drops.
  2. 2
    Calibration — The laser is calibrated according to the parameters calculated during your preoperative assessment.
  3. 3
    Treatment — The excimer laser performs the correction. The actual laser time is from a few seconds to a few tens of seconds depending on the technique and the correction.
  4. 4
    Finishing — For transPRK, a bandage contact lens is placed on each eye before you get up.
  5. 5
    Leaving — You leave the room with UV-protection sunglasses. You cannot drive.

Sensations by technique

transPRK

The procedure is painless. The first few hours are generally comfortable. The following 48 to 72 hours may be accompanied by stinging, watering and sensitivity to light (photophobia). The bandage contact lens limits corneal discomfort during the epithelial healing phase.

FemtoLASIK

Almost painless during and after the procedure. A slight foreign-body sensation may persist on the first day. Visual recovery is significantly faster than with surface surgery.

Step 4

Postoperative course

Eye drops, restrictions and visual recovery

transPRK

First few days

  • Stinging and watering for the first 48–72 hours
  • Photophobia: wear your sunglasses outdoors
  • The bandage contact lens is removed at the first postoperative consultation (D3–D5)
  • Instil the prescribed eye drops according to the set schedule

First week

  • Avoid any contact of the eyes with water for 5 days (shower below the neck)
  • Do not rub your eyes
  • Blurred and fluctuating vision: normal during the epithelial healing phase
  • Return to everyday activities: about 1 week depending on progress

First few weeks

  • No swimming or sea water for 3 weeks
  • Transient night-time halos and glare possible
  • Vision stabilises gradually over 2 to 4 weeks
  • Anti-inflammatory eye drops are continued according to the protocol

FemtoLASIK

First few days

  • Slight foreign-body sensation on the first day
  • Functional vision within 24 hours
  • Instil the prescribed eye drops
  • Sunglasses for the first few days

First week

  • Avoid rubbing your eyes: the corneal flap must adhere without mechanical stress
  • No contact of the eyes with water for 5 days
  • Return to everyday activities: 24 hours

First few weeks

  • No swimming for 3 weeks
  • Night-time halos and glare possible, generally transient
  • Dry eye: common, treated with artificial tears
  • Avoid contact sports: the flap remains fragile in the short term

Expected transient symptoms

Whatever the technique, fluctuating vision, halos around light sources and sensitivity to light are common in the first few weeks. These symptoms are part of the healing process and tend to ease gradually. In the event of intense pain, sudden loss of vision or marked redness, contact the department without waiting for your next appointment.

Step 5

Postoperative follow-up

Included up to 3 months — and beyond if needed

D3 – D5

First postoperative consultation. For transPRK, the bandage contact lens is removed if epithelial healing is complete. Check of the refraction and the corneal surface.

1 month

Check of the refraction, corneal topography and healing. Adjustment of the eye-drop protocol if needed.

3 months

Included end-of-follow-up assessment. Evaluation of refractive stability, vision quality and the ocular surface. At this stage, the great majority of patients have reached their final visual result.

Beyond

An annual check, or one if the refraction changes, is recommended in the long term. If an enhancement proves necessary — a residual correction after complete healing — it is discussed during the postoperative consultations.

Follow-up is an integral part of the procedure. The quality of the visual result is built as much in the operating theatre as over the course of the postoperative consultations.

Dr Alexandre Balon

Your journey begins
with a consultation

The preoperative consultation is the only point at which the surgical decision can be made. Contact Clinique Saint-Pierre Ottignies to arrange an appointment with Dr Alexandre Balon.

Book an appointment → The surgical techniques
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