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Wavefront Optimized versus Wavefront Customized

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.

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