Customizing LASIK surgery to provide each patient with the safest and best outcome is the ultimate goal of all LASIK surgeons and laser manufacturers. However, there are many different ways of approaching this goal and there is a good deal of confusion as to which approach is best. The following information hopefully will help you to understand the differences in the technology available and allow you to make a more informed decision when confronted with these choices.
The human eye is a less than perfect optical system. Its optical defects produce distortions or "aberrations" in vision. To measure these aberrations, parallel light rays are directed into the eye passing through the cornea, lens and vitreous cavity to the retina. When these rays return to where they originated they are distorted (aberrated) to some degree. This aberration is then measured on a device that is called an aberrometer. This information can then be used by the excimer laser to correct these defects. The more specific the laser is in addressing these aberrations, the more customized the LASIK treatment will be.
First of all, traditional (or standard) LASIK surgery, using the latest software upgrades, is performed today with WAVEFRONT-ADJUSTED lasers. The current software directing the excimer lasers provides safer and better outcomes than in the past. By using WAVEFRONT technology, a new level of customization is introduced that did not exist before. When combined with a battery of test performed by your surgeon prior to surgery, excellent results can be obtained. Examples of WAVEFRONT-ADJUSTED lasers are the Visx Star S-4, the Alcon LadarVision, and the Bausch & Lomb Technolas 217a.
Next, we have WAVEFRONT-OPTIMIZED lasers of which there is only one currently approved in the U.S. The Allegretto Wave Laser System has demonstrated outstanding results in Europe where it has been in use for several years and is the best selling excimer laser there. The FDA granted the Allegretto laser the widest treatment ranges (including farsightedness) of any of the custom LASIK lasers due to its demonstrated success and safety rate. The Allegretto laser, using WAVEFRONT-OPTIMIZED technology, developed a patented algorithm, which provides outstanding results by maintaining the natural prolate shape (steeper in the center and flatter in the periphery) of the cornea after LASIK is performed. Its success rate meets or exceeds any other excimer laser presently in use in the U.S, which explains its popularity in Europe.
Lastly, there is customized LASIK using WAVEFRONT-GUIDED lasers. These lasers create an individual treatment profile for each individual eye. These laser platforms require much more testing and are more time consuming than either the WAVEFRONT-ADJUSTED or the WAVEFRONT-OPTIMIZED laser treatments. Examples of WAVEFRONT-GUIDED lasers are the Visx Star S-4 Custom Vue Excimer Laser System, and Visx WaveScan Wavefront System with WavePrint mapping; the Alcon LadarVision Custom Cornea; and the Bausch & Lomb Technolas 217z Zyoptix Zywave System.
Keep in mind that the more customized the LASIK surgery, the more expensive the surgery will be. Customization requires more expensive technology, more expertise on the part of the surgeon, and more time to perform the additional testing. By using wavefront mapping your surgeon will be able to determine which treatment will best serve your needs. With the additional safety and quality of vision provided by wavefront technology, LASIK surgery has reached a new plateau.
To find out if you are a candidate for these exciting new technologies, call our office at 713 799-9040 for a FREE Consultation.
The Laser Vision Center - Chris J. Cabler, M.D. 
Dr. Cabler is a native Houstonian and fifth generation Texan. He obtained
his medical degree from The University of Texas Medical Branch in Galveston. After interning at Hermann Hospital in Houston, he completed his Ophthalmological residency at The University of Texas Medical School at
Houston.
Dr. Cabler is active in the American Academy of Ophthalmology, the American Society of Cataract and Refractive Surgery, the International Society of Refractive Surgery and other medical organizations. As a practicing ophthalmologist, Dr. Cabler provides comprehensive ophthalmological care and a full service optical center.
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