Millions of people have reduced their dependence on eyeglasses and contact lenses over the past several years with the refractive surgery procedure known as LASIK.

This procedure can correct refractive errors such as nearsightedness, farsightedness and astigmatism. Now an enhanced version of LASIK, known as wavefront LASIK, is available. This improved system allows eye surgeons to customize the procedure for each eye, providing the possibility of even better vision.

Adapted from technology used in astronomy, wavefront LASIK is a procedure that uses an array of microsensors and a laser. A wave of light from a laser beam is sent through the eye to the retina. This light is reflected out of the eye, and the sensor measures the irregularities at the front of the wave of light as it emerges from the eye. This produces a precise three-dimensional map of the visual system, including the cornea's imperfections, or aberrations. Thousands of people have the same eyeglass prescription, but because the map is so precise, no two people have the same wavefront measurements.

These wavefront data are translated into a mathematical formula the surgeon uses to program corrections into the ultraviolet cold laser, which vaporizes tissue to reshape the cornea. This new wavefront technology has a better chance of reducing higher-order aberrations that cause glare, haloes and blurry images. All wavefront patients will have some higher-order aberrations after surgery, and in fact some types of aberration may increase. However, wavefront technology is the best tool for quantifying aberrations, and wavefront LASIK results in far fewer aberrations than conventional LASIK.

Concerns about quality of vision and nighttime glare with previous forms of LASIK prevented many people from having their vision corrected. In Food and Drug Administration trials, the majority of patients who had custom LASIK found their night vision to be better after the procedure than it was with their glasses or contact lenses. One FDA study showed More than 70 percent of custom LASIK patients saw better than 20/20.

Wavefront LASIK may not be for everyone because it removes more corneal tissue than conventional LASIK. Patients with thin corneas, high degrees of aberration, severely dry eyes or conditions that affect the lens or vitreous fluid inside the eye may not be good candidates. However, many of these patients may still be good candidates for conventional LASIK. Have our LASIK of NEVADA staff check to see if wavefront LASIK is right for you.

Dr. Rothman Questions and Answers Regarding Wavefront.

1. How long has Custom Wavefront LASIK been available?
   

   Wavefront aberration mapping and image enhancement has been used in astronomy for years. The actual theory was first developed in the 1930's by a German physicist named Zernicke. The first wavefront mapping of the eye was performed in 1994. The FDA approved Custom Cornea wavefront guided LASIK in October 2002. In our research program, we have been studying corneal optics and optical outcomes for years, and have been working with corneal wavefront measurements since 1999.
   
   

2. Since Custom Wavefront LASIK is a relatively new procedure, should I wait until it is more refined?
   

   Custom Wavefront LASIK is a technologic enhancement to conventional LASIK which may be advantageous to some people. From the surgical and patient viewpoint, however, the LASIK procedures are identical (although there is additional mapping in the custom procedure). Thus, if we find you to be a good candidate, you can be confident in our experience.
   
   

3. Since Custom Wavefront LASIK is newest, shouldn't everyone having LASIK elect the custom procedure?
   

   While Custom LASIK may be very appropriate for some, it may not be necessary or even the wrong approach for others. Considerations such as the magnitude of your eye's higher-order aberrations, your pupil size, and your corneal thickness may suggest one or another procedure. 
   
   

4. After Custom Wavefront LASIK, will I see better than I do with contact lenses or glasses?
   

   In a certain percentage of custom LASIK cases, patients will see better than they did with their glasses or contact lenses. This is also true for conventional LASIK, though theoretically not as frequently. One needs to understand that although this vision improvement is possible, it is by no means guaranteed. It is still possible that you will not see quite as well as with your glasses or contacts.
   
   

5. Is Custom Wavefront LASIK "safer" than conventional LASIK?
   

   When you read about claims that Custom Wavefront LASIK is "safer" than conventional LASIK, they usually are referring to the reduced likelihood of creating night vision or glare/halo problems. Such problems can be secondary to "higher order aberrations" or static in your eye. Since custom LASIK is designed to minimize this static, the hope is that the incidence of night vision problems will be minimized. Remember, though, most conventional LASIK patients have good night vision and some Custom LASIK patients could still suffer problems.
   
   

6. For the patient, how does the Custom Wavefront LASIK experience differ from the standard procedure?
   

   The actual surgical experience for the patient is exactly the same as conventional LASIK. The difference comes in the pre-operative measurement of the wavefront aberration profile and the technique for programming the computer with your individual treatment parameters.
   
   

7. Are the results of Custom Wavefront LASIK permanent?
   

   While we understand a great deal about the eye's lower-order aberrations and their stability, we understand far less about it's higher-order aberrations. So while the laser effects of custom LASIK should be stable and permanent, no one can yet predict how one's higher-order aberrations will naturally change over the years.
   
   

8. If I have large pupils is it required that I have Custom Wavefront LASIK?
   

   While there is a tendency for those with larger pupils to have a larger degree of higher-order aberrations, this is not always the case. Pre-operative wavefront measurements will determine this degree and whether custom LASIK would be recommended over conventional LASIK.
   
   

9. I have already had LASIK and experience night vision disturbances. Can Custom Wavefront LASIK help me?
   

   Wavefront measurements of post-operative LASIK patients with such quality of vision complaints may demonstrate higher-order aberrations. Preliminary studies suggest that wavefront LASIK retreatments can reduce these aberrations, as well as subjectively improve these night vision and contrast sensitivity problems. Each patient needs to be individually assessed to make proper suggestions.