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Custom Wavefront Guided & Optimized LASIK Laser Eye Surgery

Reviewed by Jason Jacobs, M.D.

Custom Wavefront Guided and Custom Wavefront Optimized LASIK Laser Eye Surgery are types of Custom LASIK used to treat optical aberrations of the eye in addition to the common refractive errors of nearsightedness, farsightedness and astigmatism. Many patients do not realize that the eye is an imperfect optical system.

The distortions that are created are referred to as "aberrations." The vast majority--90% or more--of these aberrations create common refractive errors, such as nearsightedness, farsightedness and astigmatism, which can be treated by optical devices, like glasses and contact lenses, or by Laser Eye Surgery, using the conventional methods of LASIK, PRK, LASEK or Epi-LASIK.

The remaining 10% of optical aberrations create images which are altered by chromatic aberration, spherical aberration, diffraction, curvature of field, coma, trefoils and quadrafoils--collectively known as "higher order aberrations."

These higher order aberrations only occur in a visually significant manner in 10% to 15% of the general population. When they do occur, they are entirely unique to a particular patient--much like a fingerprint. For these patients, the use of a wavefront-guided laser eye surgery technique to create a completely customized reshaping of the surface of the cornea may be the best treatment option.

To achieve a customized corneal shaping, it will require measuring the higher order optical aberrations using a wavefront analysis system called an Aberrometer and then digitally interfacing it with a laser, using high speed computerized control to direct the delivery of a very tiny beam of laser energy across the cornea.

The Aberrometer System lets the surgeon see refractive aberrations in clear and accurate, rotating 3-D images. How does the Aberrometer do this? First, the Aberrometer sends low-energy laser light into the eye. The light reflects off the retina and travels back through the lens and cornea as an outgoing wavefront. This wavefront is captured by the Aberrometer, which then measures it to determine both higher and lower order aberrations of the entire optical system. The aberrations are then displayed on-screen in precise 3-D images.

To then create a customized corneal ablation from the Aberrometer measurements we digitally interface that data with the Excimer Laser Eye Surgery System. The Excimer Laser Eye Surgery System incorporates the use of  a high-speed computerized eye tracking method that helps the Laser Eye Surgeon enhance your treatment by providing precise registration of the laser beam to create a customized ablation surface. Since your eyes are continually making very fine jumping movements - called "saccadic" movements which are beyond your control, no matter how hard you concentrate the tracking system assists the surgeon by scanning the eye thousands of times per second. Then, using computer control, it makes micro-adjustments at speeds many times per second to reposition the pinpoint laser beam between pulses of light, tracking even the smallest and quickest movements of your eye during treatment.

In addition, the Excimer Laser Eye Surgery System uses an ultra-small beam of cool laser light - one that's less than a millimeter wide, a spot much smaller than the thickness of a single human hair. Using high-speed computer control, the Excimer Laser Eye Surgery System moves this tiny beam of light across the surface of the cornea very rapidly in a tiny, non-sequential and overlapping pattern. This helps the surgeon deliver a smooth customized corneal shape to provide you quick visual recovery and individualized correction of your prescription.

Custom LASIK & Wavefront Optimized Custom LASIK :

Custom Wavefront Guided LASIK is only one way your LASIK Surgeon can correct higher order aberration-another way is with Wavefront Optimized Laser Eye Surgery. Spherical aberration is one of the most common aberrations that we find in the eye as well as optical systems such as cameras, telescopes and microscopes. For that reason, optical device manufacturers and certain laser manufacturers include a specialized correction for the spherical aberration in their systems in order to treat these aberrations. Wavefront Optimized LASIK is useful for correcting spherical aberration which comprises what the majority of patients have, if they have higher order aberrations at all. For the vast majority of patients, Custom Wavefront Optimized LASIK will produce excellent results. For more complex prescriptions, a true Custom Wavefront Guided LASIK will be the procedure of choice.

©2011 The Medical Management Services Group

updated 4/27/12