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Wavefront Laser Technology
Customizing LASIK & Epi-LASIK Treatments

by Craig S. Bindi, MD

In 2002, the FDA approved “Wavefront Technology”
as a further refinement of the traditional LASIK procedure.
The Laser Eye Center of Silicon Valley has the distinction
for being the first private practice in the Bay Area to
offer Wavefront Technology and perform Wavefront
LASIK. On this page, I explain the how Wavefront LASIK
works and when it is useful.

“Night vision quality” is an important component of
patient satisfaction after LASIK. As Wavefront technology
has matured, the goal to preserve or even improve night
vision quality has become a reality1. In published clinical
studies, Wavefront LASIK patients tend to have better
night vision, a lower chance of needing a retreatment
and a higher chance of seeing “20/20 or better” compared to traditional LASIK methods2,7. How? Modern wavefront laser systems incorporate more detailed information into each laser treatment. By taking into account each patient’s unique eye aberrations/corneal dimensions, wavefront laser treatments are more customized than glasses, contact lenses and standard LASIK procedures. While Standard LASIK treats basic nearsightedness, farsightedness and astigmatism, Wavefront LASIK additionally treats other unique vision aberrations, which cause problems such as glare, halos, and poor night vision. he Allegretto Wave laser features a patented closed loop eye tracking technology, which translates to this laser’s ability to instantaneously track and adjust to each tiny eye movement during the treatment.

How wavefront technology helps patients
with naturally poor night vision

By measuring ALL significant pre-existing visual
aberrations prior to surgery with wavefront aberrometry,
customized wavefront lasers are able to treat the
“high order” aberrations that cause night vision
problems3,4,7. For certain patients with pre-existing
night vision problems, halos or glare, Wavefront LASIK
has been a very welcome addition.

How wavefront technology helps patients
with naturally good night vision

If you currently see fine at night with your glasses or contacts, you just don’t want to worsen your night vision during the process of having LASIK. For you, it is important to understand the effect of “induced-spherical aberration”, which is also addressed by modern wavefront technology. Original lasers could not preserve the natural aspheric corneal optical shape, which focuses light rays to a sharp point. As a result, new “spherical aberrations” were induced by the laser treatment. How? Older lasers could not effectively treat the peripheral cornea; so light rays from the untreated outer edge of the laser ablation zone remained unfocused. This would result in halos and glare at night. This was found to be the primary cause of night vision problems in patients whose night vision declined after standard LASIK. The effect of “induced-spherical aberration” was especially significant in patients with larger corrections or larger pupils. With modern “optimized” wavefront treatment profiles, these spherical aberrations can now be addressed to preserve or improve night vision after LASIK.3,4,6

The “best possible” vision results
Wavefront Laser Vision Correction currently offers the highest likelihood for obtaining the
best possible vision results. Accordingly, due to their demanding visual requirements,
U.S. Navy/Air Force fighter pilots and NASA’s Astronauts are only treated with wavefront
technology. While Standard LASIK and Epi-LASIK have been revolutionary in vision correction,
Wavefront LASIK/Epi-LASIK provides the best possible results.

• In one government-sponsored FDA clinical study, 93% of Wavefront LASIK patients
saw “20/20 or better”, and 76% better than 20/16!

• In another FDA study, 98% of patients saw 20/20 or better, and 100% saw at least 20/40 without glasses.

• With the additive benefits of Wavefront technology, it is ten-times more likely to see better
at night than worse after Wavefront LASIK/Epi-LASIK compared to glasses and contacts.1

References:

1. Comparison of night driving performance after wavefront-guided and conventional LASIK for moderate
myopia. Ophthalmology. 2009 Apr: 116(4): 702-709
2. Wavefront-guided LASIK for the correction of primary myopia and astigmatism a report by the American
Academy of Ophthalmology. Ophthalmology. 2008 Jul; 115(7): 1249-61. American Academy of Ophthalmology,
Quality Care and Knowledge Base Development, P.O. Box 7424, San Francisco, CA 94120-7424, USA.
3. Visual acuity and higher-order aberrations with wavefront-guided and wavefront-optimized laser in situ
keratomileusis. J Cataract Refract Surg. 2010 Mar; 36(3): 437-41. Perez-Straziota CE, Randleman JB, Stulting RD
4. A comparison of wavefront-optimized and wavefront-guided ablations. Curr Opin Ophthalmol 2009
Jul;20(4):247-50 Myrowitz EH, Chuck RS. The Wilmer Eye Institute, The Johns Hopkins School of Medicine,
Baltimore, Maryland 21093, USA.
5. Wavefront-guided customized corneal ablation. Curr Opin Ophthalmol. 2008 Jul;19(4):314-20. Kim A,
Chuck RS The Wilmer Eye Institute, Lutherville, Maryland 21093, USA.
6. Wavefront-guided versus wavefront-optimized laser in situ keratomileusis: contralateral comparative study.
J Cataract Refract Surg. 2008 Mar;34(3):389-97. Padmanabhan P, Mrochen M
7. Comparison of custom ablation and conventional laser in situ keratomileusis for myopia and myopic astigmatism.
Cornea 2009 Oct;28(9):971-5. Palacin E