Refractive Surgery in Toulon: Laser Eye Surgery for Myopia, Astigmatism, Hyperopia and Presbyopia

Refractive surgery covers all the laser operations and implant procedures that durably correct myopia, hyperopia, astigmatism and presbyopia, so you can live without glasses or contact lenses. More than one million operations are performed every year in Europe, with a satisfaction rate above 95%. The main techniques — PRK, LASIK and SMILE — reshape the cornea with a laser in a few minutes, under local drop anaesthesia. For patients who are not eligible for laser, phakic implants (ICL) and clear lens exchange (PreLex) offer excellent alternatives. Painless and performed as day cases, these procedures allow fast visual recovery — often as early as the next day.

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Refractive surgery: the essentials

Definition: surgical correction of refractive errors by laser or implant to live without glasses or lenses
Conditions treated: myopia, hyperopia, astigmatism and presbyopia — alone or combined
Frequency: more than one million operations a year in Europe
Laser techniques: PRK (surface treatment), LASIK (corneal flap), SMILE (lenticule extraction through a micro-incision)
Implant techniques: phakic ICL/IPCL implant (high myopia), PreLex (presbyopia + clear lens)
Results: over 95% satisfaction; the vast majority of patients reach 20/20 without correction
Contraindications: keratoconus, unstable vision, cornea too thin (→ implant), pregnancy, active infection
Stay: day case — a few hours on site
Anaesthesia: local drops (laser) / with sedation (implants)
Procedure: both eyes the same day (laser) or one eye at a time (implants)
Aftercare: antibiotic and anti-inflammatory drops for 2 to 4 weeks, artificial tears for 1 to 3 months
Recovery: 1 to 2 days (LASIK/SMILE) — 3 to 5 days (PRK)
Complications (rare): dry eye, halos, correctable residual refractive error, ectasia (exceptional), infection (exceptional)
Reimbursement: not covered by Social Security (elective surgery) — many insurers reimburse part (a €300 to €1,000 per eye allowance depending on the policy)
Dr Bourdon’s fees — €2,400 for both eyes (PRK) — €2,650 (LASIK) — €2,750 (PresbyLASIK) — €2,950 (SMILE) — €3,050 (SMILE hyperopia) — from €3,500 (phakic ICL implant) — €4,000 (PreLex). Post-operative consultations included.

Learn more: PRK · LASIK · SMILE · Phakic ICL implant · PreLex

Expert insight

“Refractive surgery is becoming ever more widespread! More precise and safer than ever thanks to the latest-generation lasers, it allows millions of patients worldwide to see without glasses or lenses every year. Today the results are excellent whatever the technique, and serious complications have become exceptional.”
Dr Hugo Bourdon

What is refractive surgery?

Refractive surgery refers to all the laser or implant eye operations that correct refractive errors so you can live without glasses or lenses. These operations treat myopia, hyperopia, astigmatism and presbyopia — and all these errors combined if needed — in a single procedure.

Three broad families of techniques exist:

Corneal lasers — PRK, LASIK and SMILE reshape the cornea with a laser to change its optical power. LASIK is the most widespread technique, followed by PRK (surface treatment, the simplest and safest) and SMILE, the most recent technique.
Phakic implants (ICL/IPCL) — a custom lens is placed in the eye to correct high myopia or patients not eligible for laser (cornea too thin or too dry).
PreLex (Presbyopic Lens Exchange) — the clear lens is replaced with a multifocal implant, as in cataract surgery. Ideal for presbyopia after 50.

Focus on myopia surgery

Myopia surgery is the best-known application of refractive surgery and the first refractive error that surgeons managed to correct. The principle is to flatten the curvature of the cornea so that images focus correctly on the retina.

PRK, LASIK and SMILE give excellent results for myopia up to about -10 dioptres. Beyond that, or with a cornea too thin to be reshaped, a phakic ICL or IPCL implant is considered. Improvements in technique have extended the applications to astigmatism, then hyperopia and presbyopia.

What are the 5 refractive surgery techniques?

The choice of technique depends on the error to correct, the thickness and shape of the cornea, the patient’s age and their expectations. Here are the five techniques.

PRK and trans-PRK — Photorefractive keratectomy

PRK is the reference technique, the simplest and the most respectful of the cornea. The surgeon reshapes the cornea directly at the surface with an excimer laser, without cutting it. Trans-PRK, its evolution, is 100% laser: the surgeon operates without even touching the eye.

PRK corrects myopia, astigmatism, and to a lesser extent hyperopia and presbyopia. The healing time is a little longer (3 to 5 days) than with LASIK, but the results are just as excellent. It is the operation most often chosen by ophthalmologists who have surgery themselves. Learn more about PRK.

LASIK — Laser in situ keratomileusis

LASIK is the most widely performed refractive surgery technique in the world. It combines two lasers: a femtosecond laser first creates a corneal flap (lenticule) 110 µm thick, then an excimer laser reshapes the cornea underneath. The flap is then laid back like a natural dressing, which considerably speeds up recovery.

LASIK corrects all refractive errors: myopia, astigmatism, hyperopia and presbyopia (PresbyLASIK). Visual recovery is almost immediate — most patients see well from the next day. Learn more about LASIK.

SMILE — Small Incision Lenticule Extraction

SMILE (formerly Relex SMILE) is the most recent corneal refractive technique. A single laser (the femtosecond) cuts a thin lenticule directly within the thickness of the cornea, changing its curvature. This lenticule is then extracted through a 3 mm micro-incision — versus 20 mm for the LASIK flap.

SMILE is seen as an evolution of LASIK. Visual recovery is just as fast, but the risk of dry eye is lower and the complications linked to the corneal flap do not exist. SMILE corrects myopia and astigmatism, and recently hyperopia (hyperopic SMILE). Learn more about SMILE.

Phakic implants ICL and IPCL

Phakic implants are intraocular procedures that correct refractive errors when laser is contraindicated. If the cornea is too thin, too fragile, too dry or the myopia too high (beyond -10 dioptres), a custom soft artificial lens is inserted through a 2.4 mm micro-incision behind the pupil.

These implants are a great help for patients with extreme myopia, high astigmatism and some types of hyperopia. Visual quality is excellent, the procedure is reversible (the implant can be removed), and the results are durable. More than one million ICL implants have been placed worldwide with over 20 years of hindsight. Learn more about the phakic ICL implant.

PreLex — Presbyopic Lens Exchange (clear lens)

PreLex treats presbyopia combined with other refractive errors in patients over 50. The principle: the crystalline lens (the eye’s natural lens) is aspirated and replaced with a multifocal implant, exactly as in cataract surgery.

The results are definitive and durable. The patient gets full treatment of their presbyopia and will no longer need cataract surgery later. The implant never needs to be changed during life. Learn more about PreLex.

Which vision problems can be operated on?

Refractive surgery corrects refractive errors, the vision defects normally compensated by glasses or lenses. Combined treatments (myopia + astigmatism, or hyperopia + astigmatism + presbyopia, for example) can be done in a single operation.

Refractive error	Anatomical defect	Symptoms	Laser correction
Myopia	Eye too long or cornea too curved	Blurred distance vision	Flatten the centre of the cornea
Hyperopia	Eye too short or cornea not curved enough	Eye strain, headaches	Steepen the cornea in the periphery
Astigmatism	Oval cornea (rugby ball)	Smeared, distorted vision	Flatten the cornea along the steep axis
Presbyopia	Loss of lens elasticity	Reduced near vision after 43	Monovision or multifocality

Myopia — blurred distance vision

Myopia corresponds to an eye that is too long or a cornea that is too curved: the image focuses in front of the retina, making distance vision blurred. The limit of clear vision is inversely proportional to the myopia: a -1 myope sees clearly up to 1 metre, a -5 myope up to 20 cm, and a -10 myope up to 10 cm. Laser surgery flattens the centre of the cornea to reduce the eye’s optical power.

Hyperopia — the eye is always straining

Hyperopia corresponds to an eye that is too short or a cornea that is not curved enough: the image forms behind the retina. To compensate, the lens is constantly accommodating, which causes eye strain, headaches at the end of the day, and sometimes a squint. Laser surgery steepens the cornea in the periphery to increase the eye’s refractive power.

Astigmatism — smeared vision at all distances

Astigmatism is a deformation of the cornea along one axis: rather than a sphere (a football), it becomes oval (a rugby ball). Vision is smeared and distorted, both far and near. Astigmatism is often combined with myopia or hyperopia. Surgery flattens the cornea in its steepest area to restore a regular spherical shape.

Presbyopia — reduced near vision after 43

Presbyopia appears around 43-45 and affects 100% of the population. The lens loses its flexibility and can no longer focus for near vision. Surgery compensates for this loss of accommodation, either by creating a slight myopia on the non-dominant eye (monovision) or by creating a magnifying effect (multifocality). Laser suits small presbyopia (up to 1.5 dioptres); beyond that, an implant technique (PreLex) is more effective.

Are you eligible for refractive surgery?

Any patient who wears glasses or lenses is potentially a candidate for refractive surgery. The main eligibility criteria are:

A minimum age of 18 (ideally over 21) so that the eye has finished growing
Stable vision for at least 2 years (change below 0.50 dioptre)
A cornea thick enough to withstand laser reshaping — otherwise a phakic implant is offered
Laser correction limits: about -10 for myopia, -6 for astigmatism, +8 for hyperopia, +1.5 for presbyopia. Beyond that, an implant technique is considered
No progressive eye disease — in particular no keratoconus, uncontrolled glaucoma or active retinal disease
Motivation and realistic expectations — the surgeon ensures expectations match the expected results

What are the contraindications?

Keratoconus — a corneal weakness causing progressive deformation. Laser is strictly contraindicated as it would weaken the cornea further. A phakic implant may sometimes be considered.
Active corneal infections — corneal abscess, ocular herpes. Surgery must be postponed until full recovery.
Severe uncontrolled dry eye — significant dryness could worsen after surgery. However, moderate, treated and stable dryness does not contraindicate surgery, especially PRK or SMILE (gentler on the corneal nerves).
Pregnancy and breastfeeding — hormonal changes can temporarily alter the refraction, and the safety antibiotic drops are not compatible with pregnancy. Surgery is postponed until after breastfeeding.
Refractive instability — if vision is still changing significantly, you must wait for it to stabilise before operating.

Myths about refractive surgery

Many patients hesitate to have surgery because of misconceptions, sometimes passed on by their own ophthalmologist. Let’s separate fact from fiction:

My glasses prescription is slightly different, so my vision is still changing.

False. Stability in refractive surgery is defined as a change in correction above 0.50 dioptre over 2 or 3 years. After 23-25 years of age, it is extremely rare for vision to change that much. And if vision does change a few years later, a touch-up is often possible.

It is better to wait until after having children because pregnancy changes vision.

False. Pregnancy causes hormonal changes that can very slightly alter vision, but these variations are minimal, not bothersome and entirely reversible once breastfeeding ends.

Being myopic protects me from presbyopia.

False. Presbyopia affects 100% of the population from 43-45 years, myopic or not. A mild myope can take off their glasses to read, but will wear progressive lenses 100% of the time. A patient who has had myopia surgery will only need a pair of backup reading glasses when presbyopia comes, and will remain free of distance glasses. A touch-up to compensate for presbyopia is even possible.

My eyes are dry, so I cannot have surgery.

False. Only severe, uncontrolled dryness is a contraindication. Moderate, treated and balanced dryness poses no problem for PRK or SMILE, which better preserve the corneal nerves.

You can go blind after laser eye surgery.

Extremely unlikely. No case of complete blindness has been reported after corneal laser refractive surgery. The laser does not enter the eye and touches neither the retina nor the optic nerve. Serious complications are exceptional and treatable. Refractive surgery is one of the safest procedures in the world.

What does the pre-operative assessment involve?

The pre-operative assessment is an essential step: it identifies your expectations, evaluates the health of your eyes and chooses the most suitable technique. It must be carried out at a dedicated consultation.

Important: do not wear soft contact lenses for the 3 days before the consultation (7 days for rigid lenses). State your motivation when booking a “refractive surgery assessment” appointment, or mention it at the start of the consultation.

The assessment steps are:

History — motivation, visual habits, occupation, hobbies, sports, medical history, allergies
Refraction and visual acuity — measuring your optimal correction, your best corrected vision and determining the dominant eye
Corneal topography — a 3D reconstruction of your cornea: thickness (pachymetry), curvature (keratometry), screening for suspicious deformities (keratoconus)
Cycloplegia — measuring the refraction under drops that paralyse accommodation, to reveal the true correction of the eye at rest. Essential in young or hyperopic patients.
Aberrometry (if needed) — measuring the optical aberrations by day and night, to personalise the laser treatment
Meibography (if needed) — assessing the Meibomian glands to estimate the risk of post-operative dryness

How does laser eye surgery proceed?

After the pre-operative assessment comes the operation. It takes place at the laser centre (for laser techniques) or at the clinic (for implants), as a day case. You will only spend a few hours on site.

Preparation on the day

Do not wear soft lenses for the 5 days before surgery (7 days for rigid lenses)
Wash your face and hair with mild soap. Do not wear make-up. Long hair down for a comfortable headrest
Arrange someone to take you home (driving is impossible after the procedure)
Bring a means of payment: cheque or bank card (mind the limit)

PRK and trans-PRK procedure

PRK is the fastest operation. It needs only one laser (excimer). Trans-PRK is the 100% laser version: the surgeon operates without touching the eye. After positioning under the excimer laser, anaesthesia and disinfection, a sterile drape and a lid speculum are placed, the eye is tracked in 3D, then the laser treatment lasts about 10 seconds (myopia/astigmatism) to 20 seconds (hyperopia). A bandage contact lens is placed (removed at day 4). The procedure is repeated on the other eye. Total time: under 10 minutes.

LASIK procedure

LASIK uses 2 successive lasers and is therefore slightly longer. Under the femtosecond laser, a stabiliser (a painless suction sensation) is placed on the eye and the corneal flap is created in about 10 seconds; vision blurs momentarily. The same is done on the other eye, then the patient moves under the excimer laser. After disinfection, the surgeon lifts the corneal flap and the excimer laser reshapes the cornea (10-20 seconds). The flap is carefully repositioned and a bandage lens may be placed for safety. Total time: about 15 minutes.

SMILE procedure

SMILE is an evolution of LASIK. It needs only the femtosecond laser and removes the risks linked to the flap. Under the femtosecond laser, a stabiliser is placed on the eye and the laser cuts a lenticule within the thickness of the cornea in about 10 seconds; a veil forms from the periphery towards the centre. The same is done on the other eye. After moving to sterile conditions, the surgeon extracts the lenticule through a 3 mm micro-incision. Total time: about 15 minutes.

Phakic implant procedure (ICL/IPCL)

Performed at the clinic in one or two stages, with an anaesthetist present for sedation. After positioning in the operating room, local anaesthesia (drops + anaesthetic gel) and careful disinfection, a 2.4 mm micro-incision is made on the side of the eye. The implant is injected and unfolds and positions itself behind the pupil. An intracameral antibiotic is instilled. The incision is self-sealing (no suture). For a bilateral procedure, the equipment is fully changed and the operation is repeated on the other eye. Duration: 10 to 30 minutes per eye.

PreLex procedure (multifocal implant)

Performed in two stages (one eye per week), exactly like cataract surgery with a multifocal implant. An anaesthetist is always present. Under the microscope, with local anaesthesia and sedation, a 2.2 mm micro-incision is made, the lens capsule is opened and the lens is aspirated (phacoemulsification). The multifocal implant is injected and unfolds in the capsule. An intracameral antibiotic is given and the incision is self-sealing. Duration: 15 to 30 minutes per eye. The other eye is operated a few days later.

Comparison of refractive surgery techniques

	PRK	LASIK	SMILE	ICL implant	PreLex
Visual recovery	3-5 days	24 hours	24-48 hours	24-48 hours	1-7 days
Post-op pain	Mild to moderate	None or mild	None or mild	None or mild	Mild to moderate
Back to work	3-5 days	24 hours	24 hours	24-48 hours	1-3 days
Myopia	Yes (to -8)	Yes (to -10)	Yes (to -10)	Yes (to -18)	Yes
Hyperopia	Partly	Yes (to +6)	Yes (recent)	Yes	Yes
Astigmatism	Yes	Yes	Yes	Yes (toric)	Yes (toric)
Presbyopia	Partly	Yes (PresbyLASIK)	Partly	No	Yes (multifocal)
Thin corneas	Yes	No	No	Yes	Yes
Post-op dryness	Less frequent	More frequent	Less frequent	Rare	Rare
Reversibility	No	No	No	Yes	No
Touch-up possible	Yes	Yes	Less easy	Laser touch-up	Laser touch-up
Dr Bourdon fee (both eyes)	€2,400	€2,650	€2,950	From €3,500	€4,000

Visual recovery and pain after surgery

Recovery speed depends on the technique and the error corrected. Whatever the technique, pain is prevented and treated with suitable painkillers. LASIK and SMILE allow a return to work and driving within 24 hours, with little or no pain; PRK takes 3 to 5 days with mild to moderate discomfort. In LASIK, distance vision recovers within 24 hours for myopia and astigmatism, but can take 1 to 12 weeks for hyperopia and 1 to 6 weeks for presbyopia, while near vision recovers within 24-48 hours.

Aftercare and recovery

Post-operative treatment prevents infection, inflammation and dryness. The typical protocol is:

Antibiotic and anti-inflammatory drops (Tobradex®) — 1 drop 3 times a day for 2 to 4 weeks
Artificial tears (Thealoz® or Celluvisc®) — for healing and dryness, for 1 to 3 months
Paracetamol + codeine — oral painkiller, especially after PRK
Cold mask — for pain relief and decongestion, especially after PRK

Timing	Possible activities
Day 1 to 5	Back to work (day 1 for LASIK/SMILE, day 3-5 for PRK)
7 days	Gentle sport (stationary bike, yoga), water running over the face
15 days	Intense sport, make-up
1 month	Combat sports, water sports (pool, sea)

Essential precautions

Wash your face with a clean flannel and mild soap during the first week
Do not submerge your head in water for 2 to 3 weeks
Do not wear make-up for 2 to 3 weeks
Never rub your eyes compulsively — for life!
Wear category 3 sunglasses in case of strong UV exposure during the year after surgery

What are the risks and complications?

Complications in refractive surgery are rare. The post-operative period can sometimes be longer than expected, but long-term after-effects are exceptional. The main risks are:

Risk / complication	Frequency	Management
Residual refractive error	3-5%	Laser touch-up weeks to months later
Dry eye	Common (LASIK ++, PRK and SMILE less)	Artificial tears, resolves in 1-3 months
Night-time halos	Common at first	Decrease over time (neuroadaptation)
Corneal ectasia	Exceptional	Cross-linking ± implant
Infection (corneal abscess)	Exceptional	Reinforced antibiotic drops
Inflammation (DLK / haze)	Rare	Prolonged corticosteroids

Cost of refractive surgery

Refractive surgery is considered elective surgery: it is not reimbursed by Social Security. However, more and more insurers offer coverage allowances (from €300 to €1,000 per eye depending on the policy). Remember to check with your complementary health insurer and to send them the quote.

Technique	Both eyes	Per eye
PRK and trans-PRK	€2,400	€1,200
LASIK	€2,650	€1,400
PresbyLASIK	€2,750	€1,500
SMILE	€2,950	€1,500
Hyperopic SMILE	€3,050	€1,550
Phakic ICL implant	From €3,500	—
PreLex	€4,000 (€2,400 if early cataract)	€2,000

Post-operative consultations are included in the price of the procedures. The cost of laser surgery is generally recouped within 4 to 5 years compared with recurring spending on glasses and lenses (€250 to €600 a year on average).

Frequently asked questions about refractive surgery

Is laser eye surgery painful?

No. Local drop anaesthesia numbs the eye and prevents any pain during the procedure. Some patients feel passing pressure or discomfort, but never pain. After surgery, mild discomfort or a foreign-body sensation can occur, especially with PRK, and clears within a few days with the prescribed painkillers.

How long does refractive surgery take?

The laser itself lasts only a few seconds to a few minutes per eye. With preparation, total time in theatre is about 10 minutes for PRK, 15 minutes for LASIK or SMILE, and 15 to 30 minutes per eye for phakic ICL implants or PreLex.

Will my vision be perfect after surgery?

The vast majority of patients (over 95%) reach 20/20 without correction. However, perfect vision cannot be guaranteed 100%. Some patients may keep a need for backup glasses in specific situations (night driving, prolonged reading). In case of under-correction, a touch-up is often possible.

Which is the best refractive surgery technique?

The best technique is the one your surgeon masters best and that is most suited to your eyes. From a safety standpoint, PRK is the simplest and most cornea-sparing: it is the operation most often chosen when an ophthalmologist wants surgery themselves. LASIK offers the fastest recovery, and SMILE the best compromise between speed and dryness.

When can you drive again after surgery?

After LASIK or SMILE, driving is usually possible the next day. After PRK, allow 3 to 5 days. The surgeon checks visual acuity at the follow-up visit before clearing you to drive. A medical certificate confirming no need for optical correction can be issued.

When can you do sport again after surgery?

Gentle sport (stationary bike, yoga) can resume after 7 days. Intense sport after 15 days. Combat sports and water sports (pool, sea) after 1 month. Avoid activities with a risk of eye trauma during this period.

Is laser eye surgery reimbursed?

No. Refractive surgery is considered elective surgery and is not covered by Social Security. However, many insurers offer reimbursement allowances of €300 to €1,000 per eye depending on the policy. It is best to check with your complementary insurer before surgery.

What are the risks of refractive surgery?

Complications are rare. The most common are transient dry eye and halos, which decrease over time. Residual refractive error (3-5% of cases) can be corrected by a touch-up. Serious complications (infection, corneal ectasia) are exceptional. Corneal refractive surgery is one of the safest surgical procedures in the world.

PRK or LASIK: how to choose?

LASIK offers faster recovery (24h versus 3-5 days for PRK) but needs a thicker cornea and causes more dry eye. PRK is safer for thin corneas, patients at risk of dryness or jobs with a risk of eye trauma (military, combat athletes). SMILE is a good compromise between the two.

Can both eyes be operated at the same time?

Yes, for laser techniques (PRK, LASIK, SMILE) both eyes are routinely operated on the same day. For intraocular implants (ICL, PreLex), the two eyes are operated a few days apart for safety reasons.

Is the result permanent or will a touch-up be needed?

The results of refractive surgery are stable and durable in the vast majority of cases. However, the eye keeps ageing naturally: presbyopia will appear around 43-45 in all patients, and a cataract will develop later. A touch-up for residual refractive error is possible in 3 to 5% of cases, and a touch-up to compensate for presbyopia is possible years later.

How much does laser eye surgery cost in Toulon?

Dr Bourdon’s fees in Toulon for both eyes (post-operative consultations included) are: PRK €2,400, LASIK €2,650, PresbyLASIK €2,750, SMILE €2,950, hyperopic SMILE €3,050, phakic ICL implant from €3,500, PreLex €4,000. Many insurers reimburse part of the cost.

From what age can the eyes be operated with laser?

The minimum age is 18, ideally 21, to ensure the eye has finished growing and vision has been stable for at least 2 years (change below 0.50 dioptre). There is no maximum age: LASIK and PRK can be done up to 50-55 years. Beyond that, PreLex is often more suitable.

Can you have surgery with keratoconus?

Laser (PRK, LASIK, SMILE) is strictly contraindicated with keratoconus as it would weaken the cornea further. A phakic ICL implant may sometimes be considered after the keratoconus has stabilised. Screening for keratoconus is an integral part of the pre-operative assessment (corneal topography).

Can you go blind after laser eye surgery?

Extremely unlikely. No case of complete blindness has been reported after corneal laser refractive surgery. The laser does not enter the eye and touches neither the retina nor the optic nerve. Serious complications (infection, ectasia) are exceptional and treatable. Refractive surgery is one of the safest surgical procedures in the world.

Sources and references

Article written and reviewed by Dr Hugo Bourdon, ophthalmic surgeon at the Clinique Saint-Michel ELSAN and the Centre Iris – Institut Toulonnais d’Ophtalmologie (281 rue Jean Jaurès, Toulon). Last updated: 16 April 2026.