There are two common forms of wavefront LASIK.  These are known as Wavefront Optimized LASIK and Wavefront Customized LASIK.  Some excimer laser systems offer the surgeon the choice between either of these or even allows the surgeon to use both of them. 

Custom Wavefront treatment uses a measurement of the patient’s optical aberrations to create a laser profile that can reduce the total optical aberrations of the eye to zero.  While the system’s aim is to provide the best possible correction, the ability to actually provide this benefit is limited by the size of the laser beam, the accuracy of the beam, the accuracy of the eye tracker, the variability in healing, the variability in light absorption by the cornea, the variability in the laser beam strength, the variability in measuring the eye’s aberrations, the changes in the tear layer at the surface of the cornea, and many other factors.

Although the goal of a perfect correction for the individual eye is sought, it is in fact an impossible dream.  No measurements can perfectly match the eyes optical needs at all times and in all conditions.  Changes in humidity, light levels, environment, etc. can all cause a change in the eyes focusing.  Custom wavefront at best can only provide the correction that a patient needed at one particular time.  Despite this limitation, customized wavefront correction does in fact provide a benefit over standard LASIK.

Another LASIK correction that can be performed is wavefront optimized LASIK.  Unlike wavefront customized LASIK, wavefront optimized does not depend on a patient’s personal  aberration profile when it determines a patient’s needs.  Instead, it uses the patients glasses prescription and using a complex nomogram determines the most accurate profile that can incorporate many of the elements that can provide variability in custom LASIK.  It does not depend on measurements at any one time but uses the results of past patients to determine an ideal laser profile.

Wavefront optimized LASIK can be preferred in cases where a patient’s aberration profile is very variable or when a patient has very low levels of aberrations.  Wavefront customized LASIK would be preferred in cases where a patient has very unique aberrations or when a patient has had prior LASIK surgery.

Before having LASIK surgery ask your surgeon whether he/she will use waverfront LASIK.  Generally the answer should be yes.  Next ask your surgeon if he/she will use customized or optimized LASIK.  The surgeon should explain which one and why. 

Remember that it is always a good idea to seek more than one professional opinion.  Find the LASIK surgeon who you feel can provide the best treatment.  This includes finding out what technology that the LASIK surgeon provides and becoming educated about your choices.

LASIK Wavefront surgery continues to advance in technology and provides over a million eyes with excellent vision every year in the United States.  Despite its phenomenal success, LASIK surgery is not without its controversy and patients can often be confused by the marketing information that is provided to patients.  LASIK technology and the excimer laser systems used in LASIK surgery is one area of some confusion.

In regards to LASIK laser vision correction, there are several technologies that are important to consider.  The first is the excimer laser system that will be used.  All excimer laser systems are not equal.  It is safe to say that regardless of the skill of the surgeon, any excimer laser system in use prior to 2001 is definitely outdated and cannot provide an adequate level of accuracy and performance.  It is generally recommended for a patient to have wavefront correction unless the surgeon can provide a reason that this laser vision correction procedure would not be ideal. 

What is wavefront correction?   Wavefront measurements rely upon numerous rays of light to determine the correction needed for the entire optical system.  It creates a very detailed image of the eye’s optical system and is more exact than a glasses or contact lens prescription that can be obtained at an optometrist’s office.  These detailed measurements have been shown to provide an increased level of vision performance after LASIK surgery and patients who have wavefront LASIK correction are measured with fewer post-surgery optical aberrations.

Many LASIK surgeons no longer ask patients if they would prefer standard LASIK or Wavefront LASIK.  They have decided that wavefront LASIK provides a higher degree of visual success and therefore provide wavefront LASIK to every patient.

In fact, wavefront LASIK is not all equal.  With many different wavefront excimer laser systems on the market, you should find out the strengths and weakness of the various systems.  Ask your surgeon which system they use and why.  Find out what they feel are the strengths and weaknesses of the other systems. 

Come visit with Dr. Stephen Turner to determine if you are a good candidate for LASIK vision correction.  Turner Eye Institute is a leading vision correction clinic in the San Francisco Bay Area.  It provides treatment for near-sightedness, far-sightedness, astigmatism, cataracts, difficulty reading, and many other eye problems.  Call and talk to our friendly staff.

Stephen Turner, MD is now using Corneal Collagen Crosslinking with Riboflavin (C3R) as a treatment for patients with keratoconus.  Recent evidence and studies are showing that Corneal Collagen Crosslinking with Riboflavin (C3R) strengthens the corneal structure and can help prevent the progression of keratoconus.  CR3 works by increasing collagen crosslinking, giving the cornea greater ability to withstand degeneration that occurs in diseases such as kerataconus.  The newly strengthened cornea protects against the bulging out and becoming steep and irregular, consequence of advanced keratoconus.
Keratoconus is a disease of the cornea that occurs in about 1 in 2000 Americans.  It manifests as the cornea become weak and loses its shape, gradually causing a blurred image on the retina. Generally, it is the bottom half of the cornea that becomes distorted and vision loss first presents itself as irregular astigmatism.  At first glasses or contact lenses can correct for this distortion but in advanced stages of keratoconus, glasses and contact lenses are much less effective.  Although keratoconus causes irregular astigmatism, most forms of astigmatism are not related to keratoconus and are simply the effects of a slightly oval shaped cornea.  In the early stages of keratoconus (forme fruste keratoconus), optometrists can often assist a patient by prescribing glasses or contact lenses.  Some contact lenses have been designed to specifically help those who suffer from keratoconus.  Advanced stages of keratoconus require surgical intervention to obtain good vision.
Corneal Crosslinking with Riboflavin, C3R treatment, is performed at Turner Eye Institute. During this advanced treatment, riboflavin drops are applied to the surface of the cornea.  These drops will absorb into the cornea and are used to trigger the crosslinking inside the corneal stroma.  The riboflavin drops are activated by exposure to low doses of ultraviolet light under carefully measured treatments by Dr. Stephen Turner.  Clinical studies are showing that CR3 treatment increases the amount of collagen cross-linking in the cornea in order to strengthen the cornea. In studies at clinics in Europe, Asia, and America, CR3 treatments were demonstrated to be both safe and effective for keratoconus patients.

Dr. Stephen Turner is combining CR3 treatment and Intacs surgery to provide the highest level of treatment for keratoconus patients in the San Francisco bay Area.  Dr. Stephen Turner’s extensive experience with keratoconus and specialty in corneal treatments provide an excellent opportunity for patients with keratoconus to have the best chance of good vision. 

CR3 treatment could also be a treatment option for a rare complication of LASIK known as corneal ectasia.  This complication occurs in fewer than 1 in 10,000 treatments and has become even more rare with advances in LASIK treatments.  Dr. Stephen Turner’s Thin Flap LASIK is effective at preventing the rare complication from occurring.