Ophthalmology consultations Lausanne
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Swiss Visio Montchoisi
Av. du Servan 38
1006, Lausanne
Access & Reception

Keratoconus treatment in Switzerland

Cross-linking, intracorneal rings and lamellar transplants by Dr Arthur Hammer, FMH ophthalmic surgeon

Md-PhD, FEBO, FEBOS-CR, CertLRS, PGDip-CRS, FWCRS

Keratoconus gradually thins and distorts the cornea, which takes on a cone shape and creates an irregular astigmatism that spectacles cannot fully correct. Dr Arthur Hammer, FMH ophthalmic surgeon specialising in the cornea, manages keratoconus in Lausanne and Geneva.

Treatment is not decided on how the cornea looks at a single moment, but on how it is changing. Progressive keratoconus has to be stabilised. Stable keratoconus calls for monitoring and a suitable optical correction. Comparing topographies/tomographies over time is what settles the question.

That distinction requires a close reading of the cornea. Dr Hammer is MD-PhD, FEBO and FEBOS-CR, and corneal surgery is at the centre of his practice: it is this expertise that helps detecting early distortion before any drop in vision, and matching the appropriate procedure to the real stage of the disease.

The range of treatment covers every stage: Special contact lenses when spectacles are not enough, collagen cross-linking to halt progression, intracorneal rings and segments or topo/wavefront guided PRK to regularise a cornea already distorted, and lamellar or penetrating transplants once the cornea no longer allows any satisfactory correction.

Your corneal assessment at Swiss Visio Montchoisi, Lausanne

Before any decision, a full map of the cornea establishes the stage of the keratoconus and, above all, whether it is still progressing. Topography, tomography, corneal OCT and pachymetry are all carried out on site.

Stabilising the cornea, then restoring vision

Corneal collagen Cross-Linking (CXL)
Implantable contact lenses (ICL/IPCL)
Intraocular lenses
DALK
Penetrating Keratoplasty (PKP)
Refractive surger after a graft
Keratoconus Surgery
ICRS & CAIRS
Customised (Trans)PRK

Corneal, cataract and refractive procedures performed in Lausanne

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Laser eye surgery: Recovery

Laser refractive surgery offers a remarkably rapid recovery, with most patients experiencing a significant improvement in functional vision within 24 to 48 hours.
Refractive surgery

LASIK laser eye surgery

LASIK is a rapid and painless laser procedure that corrects refractive errors including short-sightedness (myopia), long-sightedness, astigmatism, and presbyopia. By remodelling the cornea under topical anaesthesia, it provides exceptional results, with many patients achieving clear vision as early as the following day.
Refractive surgery

PRK (Photorefractive Keratectomy) laser eye surgery

PRK (Photorefractive Keratectomy) is a surface-based laser refractive procedure that reshapes the cornea to correct vision.
Refractive surgery
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Corneal and ocular conditions managed at the clinic

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Fuchs' Endothelial Dystrophy

Fuchs’ endothelial dystrophy is a progressive condition that causes the cornea to cloud, resulting in misty or "foggy" vision that can significantly interfere with daily life.
Cornea/ocular surface

Corneal swelling (endothelial failure)

Endothelial decompensation occurs when the cornea’s internal pump fails, causing fluid buildup (oedema) and misty vision that may eventually require a transplant to restore clarity.
Cornea/ocular surface

Pterygium/Pinguecula

Pterygium and pinguecula are benign degenerations of the eye's surface tissue, often associated with UV exposure. While usually harmless, they can cause irritation or impair vision if they grow across the visual axis.
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Our news and articles

Recovery after ICL surgery: what to expect, stage by stage

Tips

Keratoconus: how the disease progresses and when to intervene

Tips

Penetrating keratoplasty: understanding the full-thickness corneal transplant

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Intracorneal ring segments (ICRS): treating keratoconus and reshaping the cornea

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Frequently asked questions about keratoconus treatment

What keratoconus treatments are offered?

Management follows the stage of the disease. Special contact lenses correct the vision when spectacles are not enough. Corneal collagen cross-linking stabilises progressive keratoconus. Intracorneal rings and segments, or a customised PRK guided by topography or wavefront, regularise a cornea that is already distorted. Lamellar transplants such as DALK or penetrating keratoplasty, are reserved for advanced stages where no correction remains satisfactory. The choice follows a full corneal assessment.

Is cross-linking covered by Swiss basic insurance?

Where it treats documented progressive keratoconus, cross-linking is in principle covered by basic insurance (LAMal), subject to the deductible and the 10% co-payment. That cover assumes progression established by comparing several topographies, which is why follow-up examinations matter. The exact terms depend on the situation and are set out at the consultation.

How is cross-linking performed and what is the recovery like?

Cross-linking is an outpatient procedure under local anaesthetic drops, taking around twenty minutes per eye with modern protocols. It combines the application of riboflavin with a controlled dose of UVA light, and ends with a bandage contact lens. After epi-off cross-linking, the first few days can be uncomfortable, with discomfort easing markedly within three to five days. Vision then settles gradually over several weeks to several months.

When are intracorneal rings used rather than cross-linking?

These two procedures pursue different aims. Cross-linking stabilises the cornea; it does not improve vision already lost. Intracorneal rings and segments aim instead to reduce the distortion so that optical correction works again. They therefore address corneas that are already markedly distorted, often once stabilised, and sometimes alongside cross-linking within the same plan.

Do you need a referral from your family doctor?

No. Direct access to the ophthalmic surgeon is possible without a referral from your family doctor, including for patients insured under HMO, family doctor or Telmed models. Appointments can be booked online through OneDoc from this site, or by telephone with the reception.

Where do consultations and procedures take place?

Dr Arthur Hammer consults at Swiss Visio Montchoisi, avenue du Servan 38, 1006 Lausanne. Implant procedures take place at the Clinique de Montchoisi, and laser procedures at Swiss Visio Beaurivage. Pre-operative corneal examinations can be carried out at Swiss Visio Montchoisi or Swiss Visio Beau-Rivage.

Can you get a second opinion before a corneal transplant?

Yes, and it is a common step. Transplantation concerns keratoconus that has reached an advanced stage and is not an inevitable stage of the disease. A full corneal assessment, compared with earlier examinations, establishes whether other options remain open. Bringing the topographies/tomographies and reports already carried out makes that second opinion considerably more useful.

Are both eyes treated at the same time?

Not necessarily. Keratoconus usually affects both eyes, but sometimes markedly asymmetrically, and each eye is assessed separately. It is common for one eye to warrant cross-linking while the other needs only monitoring. Follow-up, by contrast, always covers both eyes, including the one causing no trouble.

What should you bring to your first consultation?

Your previous corneal examinations, topographies/tomographies in particular, and your earlier spectacle or contact lens prescriptions: these are what document how the distortion has changed over time. Contact lenses must be left out for several days before the measurements, as they temporarily change the shape of the cornea. Do also mention any family history of keratoconus.