One of the latest developments in refractive surgery is wavefront technology which allows customized Lasik surgery. Dr. Hendricks uses the Visx brand excimer laser system and the FDA approved the Visx wavefront technology in the spring of 2003. Visx is always at the forefront of refractive surgery technology and it was one of the first companies to have wavefront technology/customized Lasik approved.

So what is wavefront technology? Basically, it refers to a customized Lasik treatment which is very specific to an individual eye. Let’s say you wanted a pair of gloves. You would go into a store and buy a pair of size 7 gloves in a certain color and style. This would be analogous to the standard Lasik surgery. Now let’s say you could buy a pair of gloves in a certain color and style that would also take into consideration the exact size of your hand, fingers, and even fingerprints. That would be analogous to wavefront technology and customized Lasik treatment.

So the difference between the two procedures is the way the refractive error is measured. Standard Lasik is based on the manual refraction which is done in the exam room which measures near-sightedness, far-sightedness, and astigmatism. These are known as lower order aberrations. They are also known as subjective measurements because you, the patient, help derive the numbers based on what you see through the testing lenses. The laser treatment is then based on these measurements. Wavefront technology measures lower order aberrations as well as higher order aberrations. This is done by projecting a “wave” of light into the eye. This wave is then reflected back out of the eye and is analyzed and digitized by a computer. This is an objective measurement because it is not dependent on the patient’s input. The reflected wavefront is unique to each individual eye, just like fingerprints. The laser treatment is then guided by the measurements derived from the wavefront scan.

What are the advantages of wavefront guided Lasik? Probably the biggest advantage is the potential for better quality vision. Sometimes patients that have had standard Lasik measure 20/20 but they don’t feel like they are seeing that well. This is most often due to higher order aberrations which are corrected with wavefront. The same applies to the occasional patient with night vision problems. If night vision is a concern, then you may want to consider wavefront technology. We also anticipate lower enhancement rates with wavefront technology. Our present enhancement rate is about 15% but we expect this to drop to about 5% with wavefront.

In summary, wavefront technology is another great advance that we have seen in refractive surgery. Some ophthalmologists feel this is one of the most important advances in recent times and will influence all other areas of our field and may eventually change the way we prescribe glasses and contact lenses. Dr. Hendricks feels that within a few years, all refractive surgery will be wavefront guided and it won’t even be an issue that will need to be discussed with the patient. It is not a perfect procedure and there will still need to be enhancements done at times. But it does seem to be a significant advancement that will allow us to help patients feel more satisfied with refractive surgery.

Customized Lasik is more expensive due to charges by Visx and because it is more labor intensive. Patients often want to know if it is worth the extra cost (about $300 per eye). First of all, not every patient will be a candidate because they do not fall into the parameters which the FDA has approved. If a patient does fall into the treatable category, some patients might be better candidates that others, especially if one is concerned about night vision or if one has larger than normal pupil size. Dr. Hendricks will help you decide this during your evaluation. One has to keep in mind that we have gotten great results in the past with standard Lasik and we will continue to do so. Customized Lasik is another advance and the bottom line is that it is the best we have to offer to date. If cost is not a huge issue for you, and you are a candidate, then it is worth considering. If cost is a major issue, rest assured that standard Lasik is still a great procedure.