Refractive surgery: Paris & Cachan
Hyperopia Surgery in Paris & Cachan: LASIK, SMILE, Implants
Laser correction of hyperopia (LASIK, SMILE) or implants in Paris 13 and Cachan. Dr Tourabaly, ophthalmologist.
Understanding the condition
What is hyperopia?
Hyperopia is a refractive condition characterized by an eye that is too short (axial hyperopia, the most common form) or a cornea that is insufficiently curved (refractive hyperopia). The image of nearby objects forms behind the retina, causing blurred vision mainly up close. At a distance, vision often remains sharp thanks to the focusing ability of the crystalline lens, at the cost of constant muscular effort.
Unlike myopia, which progresses during adolescence, hyperopia often decreases in childhood (as the eye grows) and then remains stable in adulthood. It affects about 25% of the adult population in population-based studies (Beaver Dam Eye Study, Blue Mountains Eye Study). Its prevalence increases with age because the eye’s focusing power gradually weakens, revealing latent hyperopia.
Symptoms and the three forms of hyperopia
The ophthalmologist classically distinguishes three forms based on age and focusing ability:
- Latent hyperopia: fully compensated by the eye’s focusing effort (typically in young adults). No symptoms at rest, but eye strain during prolonged tasks. PMID 10366072.
- Manifest hyperopia: partially compensated. Glasses are often helpful for comfort, particularly for children at school.
- Total hyperopia: cannot be compensated by focusing effort (after age 40–45, or with a stiffer crystalline lens). Glasses are required for sharp vision.
Typical symptoms: blurred near vision (difficulty reading or using a screen), end-of-day headaches, frequent blinking, eye redness and a stinging sensation. In children, severe uncorrected hyperopia can lead to accommodative strabismus and, over time, amblyopia (lazy eye), which is why early vision screening matters.
Surgical options
Operating on hyperopia: available techniques
Refractive surgery for hyperopia is technically more demanding than for myopia. The laser must reshape the periphery of the cornea (making it steeper in the center), which is more prone to long-term regression. Four main techniques are available.
1. LASIK: the reference technique
LASIK corrects hyperopia up to +5 diopters. Visual recovery is gradual over 1 to 3 weeks (slower than for myopia). The precision of the latest-generation laser (MEL 90, EX500) and aberrometry-guided customization help limit halos and glare. Returning to work is usually possible in 2 to 3 days.
2. PRK: surface laser
PRK treats hyperopia up to +4 diopters. It is preferred for patients with a thin cornea or those exposed to eye trauma. Recovery is longer (7 to 14 days), but no corneal flap is created.
3. SMILE for hyperopia (VisuMax 800)
Since 2024, the VisuMax 800 platform has extended the SMILE indication to hyperopia up to +6 diopters. This minimally invasive technique preserves the cornea’s biomechanics. Its main advantage: less postoperative dry eye and greater long-term stability compared with LASIK for moderate hyperopia.
4. ICL EVO phakic implant or PRELEX
For high hyperopia (beyond +6 D) or when the cornea is not suited to the laser, two options are available:
- Hyperopic ICL EVO: a phakic implant placed between the iris and the crystalline lens, reversible. Available up to about +10 diopters. It requires a sufficiently deep anterior chamber.
- PRELEX (PREsbyopia Lens EXchange): replacing the clear crystalline lens with a custom-calculated implant. Often offered after age 45–50, especially as presbyopia sets in at the same time. A multifocal or EDOF implant can treat hyperopia and presbyopia simultaneously.
Which technique by age and severity?
| Profile | Suitable techniques | Preferred option |
|---|---|---|
| Low hyperopia (+0.5 to +3 D), <45 years | LASIK, PRK, SMILE | LASIK or SMILE |
| Moderate hyperopia (+3 to +5 D), <45 years | LASIK, SMILE | LASIK |
| High hyperopia (>+5 D), <45 years | SMILE (VisuMax 800), ICL EVO | ICL EVO if the anterior chamber is deep |
| Hyperopia + presbyopia (>45 years) | PresbyLASIK, multifocal PRELEX | PRELEX if the crystalline lens is clouding |
| Hyperopia + cataract | Cataract surgery with a premium implant | Multifocal or EDOF implant |
Assessment and pricing
Preoperative assessment and cost of surgery
The preoperative assessment includes: refraction before and after cycloplegia (particularly important for revealing total hyperopia), corneal topography, pachymetry, aberrometry, anterior-segment OCT and a dilated fundus examination. Cycloplegia (pharmacological dilation) is essential in hyperopia to reveal the accommodative component and confirm the actual correction to be treated.
Indicative prices at Dr Tourabaly’s practice: LASIK €1,500/eye (€3,000 for both eyes), PRK €1,250/eye (€2,500 for both eyes), SMILE €1,650/eye (€3,300 for both eyes), PresbyLASIK €1,750/eye (€3,500 for both eyes), ICL EVO surgeon’s fee €1,200/eye + Clinique Sainte-Geneviève fee (€650 + €48 for both eyes) + implant on quotation, PRELEX (multifocal implant) €2,500 to €3,500/eye depending on the implant. Refractive surgery is not covered by the French health insurance system, except in specific cases (high anisometropia, documented intolerance to glasses/contact lenses). Private health plans generally offer a refractive-surgery allowance that can be activated. See refractive surgery pricing.
Consultation with Dr Tourabaly
Dr Moïse Tourabaly sees patients at the Cachan practice (94) to assess hyperopia and discuss the surgical options. Procedures are performed using latest-generation surgical equipment. Hyperopia calls for particular expertise because of the greater variability in tissue response: a detailed assessment and honest information make it possible to choose the technique suited to each patient.
Frequently asked questions
Frequently asked questions about hyperopia surgery
Regain comfortable vision
Hyperopia assessment with Dr Tourabaly
Consultation in Cachan or Paris 13 to assess the technique suited to your hyperopia.
Sources and references
- Lee KE, Klein BE, Klein R, Wong TY. Changes in refraction over 10 years in an adult population: the Beaver Dam Eye Study. Invest Ophthalmol Vis Sci. 2002;43(8):2566-2571. PMID 12147586.
- Attebo K, Ivers RQ, Mitchell P. Refractive errors in an older population: the Blue Mountains Eye Study. Ophthalmology. 1999;106(6):1066-1072.
- Reinstein DZ, Archer TJ, Carp GI. The Surgeon’s Guide to SMILE: Small Incision Lenticule Extraction, 2018.
- Kohnen T, Strenger A, Klaproth OK. Basic knowledge of refractive surgery. Dtsch Arztebl Int. 2008;105(9):163-172. PMID 19633786.
- Société Française d’Ophtalmologie. SFO Report: Refractive Surgery.
This article is for informational purposes. A personalized ophthalmological opinion remains essential for any treatment decision.