Laser eye surgery in Zurich - laser eye surgery in Switzerland

Treating long-sightedness (hyperopia) with laser eye surgery in Zurich: KRC standards & complex cases

In the morning you manage, by the evening your eyes are burning. Screen work is a strain, reading is tiring, and you keep getting headaches for which no one can find a cause. In younger people, this is often down to undetected long-sightedness: the eye is too short, and the focusing muscle compensates for this unconsciously — all day long, without a break. Long-sightedness (hyperopia) is the most demanding of the three refractive errors. At EyeLaser Zürich, we treat it strictly in line with KRC guidelines. This means that how far laser treatment (Femto-LASIK) can safely correct depends on the KRC recommendations and on your cornea. For higher values or from the age of 50, refractive lens exchange (RLE) is often the better choice. It not only corrects your vision but also protects the anatomically narrow eye preventively against glaucoma.

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In brief

Long-sightedness: where the laser reaches its limit

The laser safely corrects long-sightedness as far as the KRC recommendations and your cornea allow — that is the biological limit. For higher values or from the age of 50, lens exchange is usually the better choice. At the same time, it creates space in the eye if the anterior chamber measures less than 2.8 millimetres.

Medically reviewed by Dr. med. univ. Victor Derhartunian, FEBO, FWCRS · Specialist in ophthalmology · Last updated: 18 September 2026

Understanding the “short eye”

Long-sightedness is deceptive. Unlike short-sighted people, who notice blurred vision straight away, many long-sighted people have “eagle eyes” for years – but pay a high price for it.

Physically, your eyeball is too short. In theory, the image is formed behind the retina.

The effort (accommodation): The flexible lens bulges considerably to compensate for the error. The ciliary muscle is under constant tension – like a bicep holding a dumbbell for 16 hours.
The symptoms in Zurich: Many of our patients from the banking or IT sector do not complain about poor vision, but about tiredness in the afternoon, burning eyes or pressure in the forehead. This is often undetected long-sightedness.
The breakdown: From around the age of 40, the lens loses its focusing power. Suddenly the system breaks down: near vision becomes blurred, and often distance vision soon afterwards.

Advanced diagnostics: alpha & kappa angles

At EyeLaser Zürich, the standard is not enough for us. Especially with refractive lens exchange (RLE), detailed diagnostics make the difference between “seeing well” and “seeing very well”.

The key to quality of vision

The geometric centre of your pupil is often not the same as your actual visual axis.

Angle kappa: Long-sighted people often have a very large angle between the centre of the pupil and the line of sight.
The risk: If we simply place a standard multifocal lens “in the centre”, you look “past” it. The result: halos and glare.
The EyeLaser solution: We measure these angles with the SCHWIND Sirius. If the angle is too large, we choose special lens optics or advise against multifocal lenses. This protects you from costly disappointments.

Anatomical limits: why the laser often says “stop”

Correcting long-sightedness is technically more limited than correcting short-sightedness. To lengthen the eye optically, we have to “steepen” the cornea centrally (like building up a hill).

1. Corneal steepness (K values)

Every cornea has a natural curvature.

The limit: If your cornea is already naturally steep, we cannot make it even steeper with the laser. This would lead to severe distortions.
The KRC limit: Where the biological limit for the laser lies depends on the KRC recommendations and your corneal thickness.

2. The shallow anterior chamber (ruling out the ICL)

Many patients ask about the ICL (implantable contact lens).

The problem: Long-sighted eyes are small and narrow (“crowded eye”). The space between the cornea and the iris is often < 2.8 mm.
The consequence: There is no room for an ICL. If we implanted one, there would be a risk of glaucoma. This is why the ICL is rarely possible for long-sighted people.

The most difficult patient group: young & highly long-sighted

This is where complete honesty is required.
Imagine a patient: 30 years old, +7.0 dioptres.

Laser? Not possible (the cornea would become too steep).
ICL? Often not possible (not enough space).
Lens replacement? Critical, as the patient loses accommodation (the ability to focus).

Our philosophy:
In such cases, we often say: “No, no surgery for now.” We wait until you are older or the technology has advanced. Your eye health comes before revenue.
Exception: With extreme values (e.g. +10 D), lens replacement can be the “last resort” to restore any quality of life at all.

Find out what long-sightedness is and how we treat it

Correct your long-sightedness and enjoy life without glasses or contact lenses

The health bonus: protection against glaucoma

A long-sighted eye is a “narrow” eye. With age, the natural lens continues to grow and narrows the space even further.

The risk: People with long-sightedness have a considerably higher risk of angle-closure glaucoma (an acute rise in intraocular pressure).
The solution through lens replacement: When, from the age of 50, we replace the eye’s natural lens with a thin artificial lens, we physically create more space in the eye. The drainage channel is cleared.
Conclusion: Lens replacement not only corrects the dioptres, it is also an effective form of glaucoma prevention.

Traffic-light system for suitability

Ein Leben ohne Brille – Erfolgsgeschichten aus Zürich

🟢 Green light (ideal for laser):
- Low to moderate values (limit according to the KRC recommendations and corneal thickness).
- Age up to approx. 45.
- Normal corneal steepness.
🟡 Yellow light (lens replacement / RLE):
- Age 45+ (ideal: correction of long-sightedness + presbyopia).
- Prevention of glaucoma (narrow angle).
- Young patients with extreme values (> +8 D).
🔴 Red light (no surgery):
- Young patients (20–35) with values between +5 and +7 (anatomical dead end).
- Cornea too steep (K-values > 49 D).
- Very large angle kappa (no multifocal lenses).

Comparison of methods

Comparison: suitability for hyperopia · anatomical factor
Method	Suitability for hyperopia	Anatomical factor
Femto-LASIK	Proven within the KRC recommendations and corneal thickness.	Requires a cornea that can still be “steepened”.
Trans-PRK	Low values only.	Higher risk of regression (the correction partially wearing off).
Lens replacement (RLE)	For higher values or from age 45.	Solves the space problem in the narrow eye (glaucoma protection).
ICL (phakic lens)	Very rarely.	Often ruled out by an anterior chamber that is too shallow.

Headaches or blurred vision? Find out the cause in Zurich

We measure what is easily overlooked: angle alpha, anterior chamber depth and hidden dioptres.

✔ Measurement under cycloplegia (true values) ✔ Glaucoma risk check (narrow angle) ✔ No-obligation suitability check

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FAQ – complete answers

Here you will find answers to the questions patients ask us every day during consultations at Strehlgasse.

My eyesight is actually fine, but I often have headaches after work. Could that be long-sightedness?

Yes, that is the classic symptom of “latent hyperopia”. Your eye has to work constantly to see clearly. After 8 hours of screen work at the office, the muscle is exhausted. Headaches (often in the forehead), sensitivity to light or burning eyes are the result. We can diagnose this with eye drops that relax the muscle.

Why do I need reading glasses at 40 when my short-sighted friends do not?

Presbyopia affects long-sighted people earlier and more severely. Your focusing reserves are already used up for distance vision (“hidden long-sightedness”). When the lens then becomes stiffer, near vision fails first, followed shortly afterwards by distance vision.

Am I allowed to drive after surgery (Zurich Road Traffic Office)?

Not on the day of surgery. On the day after surgery, you come in for a check-up. With Femto-LASIK, most patients already reach the required visual acuity of 0.8 by then. As soon as we give the “OK”, you are free to drive again. If needed, we will also issue the medical certificate for the entry in your driving licence.

How long will I be on sick leave?

Femto-LASIK: You are often able to work again after 1–2 days.
Lens replacement: Vision is good quickly, but the brain often needs 1–2 weeks to adjust (neuroadaptation), especially for screen work.

I am 30 and have +6 dioptres. Why do you say “no”?

You fall into the “anatomical gap”.

For the laser, the value is too high (the cornea would become unstable).
For the ICL, your eye is too small (there is no room).
For lens replacement, you are too young (loss of accommodation).
We recommend contact lenses and regular check-ups until you become a candidate for lens replacement.

What does long-sightedness have to do with glaucoma?

A great deal. Long-sighted eyes are short and narrow. Over the years, your own lens grows and compresses the drainage channel for the fluid in the eye. The risk of angle-closure glaucoma increases. Lens replacement (RLE) removes your thick natural lens and replaces it with a thin artificial lens. This creates space and significantly reduces the risk.

What are the "alpha" and "kappa" angles?

These are axis values of your eye. If you would like a premium lens (multifocal), these angles need to be right. If angle kappa (the distance between the centre of the pupil and the visual axis) is too large, you look through the lens “at a slant”, which leads to halos. We measure this in advance and only choose lenses that suit your anatomy.

Does long-sightedness come back after laser eye surgery?

The risk of regression is somewhat higher with long-sightedness than with short-sightedness, as the cornea tries to compensate for the artificial shape at its edge. We use modern nomograms (calculation formulas) to minimise this. If a residual error remains, we can often carry out an enhancement (“fine-tuning”) after 6 months.

Will I develop cataract later if I have my lenses replaced?

No, quite the opposite. In refractive lens exchange (RLE), we remove your natural lens. Where there is no longer a natural lens, a cataract can no longer develop.

Does health insurance pay for the procedure?

Basic insurance does not (lifestyle procedure).

Exception: Extremely high values (e.g. > +6 dpt) where there is a medical need.
VVG (supplementary): Many insurers (Helsana COMPLETA PLUS, SWICA, CSS) pay contributions from supplementary insurance (often CHF 200–1’000).
Taxes: In some cantons, the costs can be deducted as “medical expenses” if they exceed the deductible (ask your tax adviser!).

Decision guide

Which procedure for which degree of long-sightedness?

Long-sightedness (hyperopia) is corrected differently from short-sightedness: the cornea is made steeper in the centre rather than flatter. This sets tighter limits for the laser, and from the mid-40s presbyopia is added on top. We treat according to the guidelines of the Commission for Refractive Surgery (KRC).

Your long-sightedness	First choice	Alternative	Why
low	Femto-LASIK 7D	Trans-PRK (low values)	Femto-LASIK is the standard procedure for long-sightedness. Trans-PRK only for low values, because regression is more common.
moderate	Femto-LASIK 7D	—	How far the laser can correct depends on the KRC recommendations and corneal thickness. For this, the cornea must still be capable of being «steepened» sufficiently.
higher	depending on age: lens replacement or ICL lens	—	The laser reaches its limit. The ICL corrects up to +10 D, but in long-sighted eyes it often fails because of the shallow anterior chamber.
any degree, from about 45	PresbyMAX or lens replacement	—	Long-sighted people notice presbyopia early. A procedure that addresses distance and near vision together is then worthwhile.
any degree, from about 50 or if the lens is clouding	Lens replacement	—	Corrects long-sightedness and presbyopia at the same time and prevents cataract. In a narrow eye, it also protects against a rise in eye pressure.

SmartSight does not correct long-sightedness; the lenticule procedure is approved for short-sightedness and astigmatism. All figures are guide values (as of September 2026).

Under 40, low to moderate values

Femto-LASIK. Allow a few weeks until your near vision is fully stable; at first, long-sighted patients often see better up close than at a distance after the laser treatment.

Around 45, reading glasses are becoming necessary

PresbyMAX corrects long-sightedness and presbyopia in one procedure, as long as your natural lens is clear. CHF 3’300 per eye.

Over 50 or higher values

Lens replacement with an EDOF or trifocal lens: all values can be corrected, and cataract can no longer develop. CHF 5’000 per eye, regardless of the implant.

Latent long-sightedness

Young long-sighted people compensate for part of it themselves. That is why we measure with dilated pupils; otherwise the correction would be too low.

What decides in the end are measurements, not tables. During the comprehensive pre-examination, we measure the front and back surfaces of the cornea, epithelial thickness, pupil and tear film (MS-39, Anterion). Only then is it clear which procedure is safe for your eye, and only then do we give you the binding price. About one in ten prospective patients leaves the examination without a surgery date. For long-sightedness, we also check the depth of the anterior chamber and the chamber angle.

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