Are you starting to juggle between several pairs of glasses \u2013 for distance, near, computer \u2013 and the idea of freeing yourself from corrective lenses is on your mind? You\u2019ve heard about SMILE laser, the true star of refractive surgery for nearsightedness and astigmatism. But what about presbyopia? Can you, after 45 years old, hope to regain clear vision without reading glasses thanks to SMILE or another technique? Let\u2019s take stock, guided by the experience of the teams at Clinique N\u00e9ovision in Lyon, on what modern eye surgery offers today.<\/p>\n
SMILE \u2013 or Small Incision Lenticule Extraction \u2013 has transformed the world of refractive surgery<\/a> since its emergence in the early 2010s. Why this enthusiasm? Because this innovative technique corrects myopia and certain astigmatisms without large cuts, through a micro-incision of less than 3 mm. The secret: a tiny lenticule of corneal tissue is removed using an ultra-precise femtosecond laser, which changes the curvature of the cornea and corrects the visual defect.<\/p>\n Myopia and astigmatism are the main indications for SMILE. However, presbyopia \u2013 which affects near vision and nearly everyone over 45 \u2013 cannot yet be effectively treated by this technology alone.<\/p>\n A complete assessment is necessary before any decision \u2013 corneal topography, biometry, precise measurement of the prescription, screening for potential contraindications. The procedure itself? Quick and painless, under local anesthesia with eye drops, less than 15 minutes per eye. No injections, no hospitalization, just the comfort of personalized support.<\/p>\n After surgery, prescription of antibiotic and anti-inflammatory eye drops, along with specific recovery instructions. Most patients leave the clinic in less than an hour and regain satisfactory vision very quickly.<\/p>\n It's unavoidable: after 45, the lens hardens and the eye can no longer focus up close. This is presbyopia. Nearsighted people notice it a little later \u2013 often when they must remove their glasses to read. But one thing is certain: no laser completely and universally reverses lens aging. SMILE, which only acts on the cornea, is no exception.<\/p>\n Currently, SMILE cannot treat isolated presbyopia. Some tricks exist for presbyopic myopes: intentionally undercorrecting one eye (usually the non-dominant) during the laser procedure to maintain comfortable near vision (\"monovision\"). This compromise works well for some, less for others \u2013 a matter of tolerance. There is not yet a \"multifocal\" SMILE capable of providing simultaneously sharp distance and near vision.<\/p>\n Therefore, if your main goal is to be free from reading glasses, other solutions should be considered. The PresbyLASIK<\/a>, for example, reshapes the cornea to induce multifocality: the corneal surface acts somewhat like a progressive lens without material form. Between 45 and 60 years old, as long as the lens is clear, this technique is the treatment of choice according to feedback from Clinique N\u00e9ovision.<\/p>\n To choose the best-suited treatment, everything depends on a customized assessment. We analyze corneal thickness, eye dominance, lens status, the possible presence of dry eye or other visual defects. Age, lifestyle, sports practice, or professional demands also factor in. Each visual issue has its personalized solution.<\/p>\n Monovision consists, during refractive surgery, of correcting one eye (usually the dominant one) for distance vision and leaving the other partially myopic to facilitate near vision. It\u2019s a proven technique, compatible with LASIK, PresbyLASIK, and certain intraocular implants. However, it is not possible with pure SMILE in isolated presbyopia.<\/p>\n Some precautions: not everyone tolerates the difference in correction between the two eyes \u2014 a trial with contact lenses beforehand is recommended to avoid any surprises after surgery.<\/p>\n Another option truly dedicated to presbyopia is PresbyLASIK. Here, the laser sculpts the cornea to provide multiple focal points (like progressive lenses but without glasses). The expected outcome: the freedom to read a text message without squinting, to enjoy screen viewing without constantly putting on glasses. This treatment remains reserved for a specific age group and a healthy cornea, but quality of life is often transformed.<\/p>\n When the lens begins to lose transparency, a multifocal implant is considered. This technique, similar to cataract surgery, offers the possibility to see clearly at all distances. Depending on the situation, options include:<\/p>\n For each case, a tailored solution in consultation with the medical team.<\/p>\n Recovery is quick. Typically, distance vision improves the next day. Mild blurriness may persist for 24 to 48 hours; light halos at night can sometimes be seen during the first days \u2013 nothing worrisome, everything normalizes as the cornea stabilizes. Most patients resume work and sports activities within 48 hours (see details on the dedicated page<\/a>).<\/p>\n Post-SMILE dry eye exists but remains moderate: on average, 2 to 4 weeks of irritation while the eye regains natural balance. Here, the benefits of SMILE are undeniable compared to other lasers.<\/p>\n Visual recovery sometimes requires more patience. Fluctuations for a few weeks are common, especially if the eye must \"learn\" to manage multiple focal points. This is called neuro-adaptation. Over time, most patients regain a freedom they sometimes forgot. Close follow-up and personalized instructions \u2013 this is the essence of quality care.<\/p>\n No surgery is without risk, although serious complication rates are below 2% for SMILE and almost always reversible. A clarification: refractive surgery, whether SMILE or PresbyLASIK, remains a comfort procedure, offered to motivated and fully informed patients.<\/p>\n There is no universal miracle solution. Patient adaptation, custom assessments, understanding the limits of each technique \u2013 that is where the true \"secret\" to success lies. Success rates are very high (especially for simple myopia and astigmatism), as evidenced by studies and patient feedback collected in Lyon and elsewhere.<\/p>\n Need to know more? The following pages answer all your questions, from scheduling an appointment to detailed comparisons between different laser methods: mixed solutions<\/a>, procedure of a SMILE<\/a>, PresbyLASIK<\/a>... Feel free to ask any questions directly to our teams during your first contact.<\/p>\n In summary? SMILE offers advanced correction for myopia and astigmatism, with record satisfaction rates and a transformed daily life from the day after surgery. For presbyopia, other lasers like PresbyLASIK or multifocal implant insertion aim for visual independence after 45. The key remains: a comprehensive evaluation, a responsive team, and a personalized solution for every eye, every life story. Ready to take the first step? Don\u2019t hesitate to make an appointment<\/a> to discuss your visual project together.<\/p>","protected":false},"excerpt":{"rendered":" Vous commencez \u00e0 jongler entre plusieurs paires de lunettes \u2013 loin, pr\u00e8s, ordinateur \u2013 et l\u2019id\u00e9e de vous lib\u00e9rer des verres correcteurs vous trotte dans la t\u00eate ? Vous avez entendu parler du laser SMILE, v\u00e9ritable star de la chirurgie r\u00e9fractive pour les myopes et astigmates. Mais quid de la presbytie ? Peut-on, apr\u00e8s 45 […]<\/p>\n","protected":false},"author":8,"featured_media":372817,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-372818","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-non-classe"],"_links":{"self":[{"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/posts\/372818","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/comments?post=372818"}],"version-history":[{"count":0,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/posts\/372818\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/media\/372817"}],"wp:attachment":[{"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/media?parent=372818"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/categories?post=372818"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/refractivechirurgie.com\/en\/wp-json\/wp\/v2\/tags?post=372818"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
The SMILE procedure, in practice<\/h3>\n
Presbyopia: a different story for refractive surgery<\/h2>\n
SMILE and presbyopia: limitations of the technique<\/h3>\n
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What are the solutions for presbyopia?<\/h3>\n
Monovision and alternatives: tailor-made for every eye<\/h2>\n
Monovision: a subtle compromise, variable results<\/h3>\n
PresbyLASIK: the \"progressive laser\"<\/h3>\n
Intraocular implants: preferred after 60 or in case of cataract<\/h3>\n
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Focus on visual recovery and follow-up after surgery<\/h2>\n
After a SMILE operation<\/h3>\n
After PresbyLASIK or multifocal implant<\/h3>\n
What risks and realistic expectations?<\/h2>\n
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Conclusion: SMILE and presbyopia \u2013 clarify your expectations, base your decision on a thorough assessment<\/h2>\n