Why Should I Choose a Wavefront Guided Procedure?

In order to correct your vision during LASIK, an excimer laser is used to reshape the front surface of your cornea.  The leading edge technology that is enhancing our ability to perform that reshaping process more accurately than ever before is called Custom Wavefront guided LASIK.  We’d like to explain why Wavefront guidance is such an exciting advance over previous methods.

You’re familiar with the high quality of TV images obtainable using High Definition technology compared to standard TV systems.  The program content is the same but the image clarity is worlds apart.  That’s the type of difference that we can observe with Wavefront guidance compared to conventional LASIK surgery.

In the past, the laser was only capable of creating shapes on the cornea that were symmetrical, like farsightedness, nearsightedness, and astigmatism.  These are the aberrations that are typically corrected by wearing glasses.  However, once you factor out these simple optical distortions, there remain additional complex shapes in the optical system that keep your eyes from seeing perfectly.  These complexities are called higher order aberrations, and include such things as: coma, trefoil, tetrafoil, and spherical aberration to name just a few.  These higher order aberrations, if not corrected during your LASIK procedure, can still leave you with imperfect optics and occasionally glare or halo side effects. 

These higher order aberrations are completely unique to your particular optical system and can now be precisely measured using a wavefront measuring device that creates an optical “fingerprint” of your visual system.  This wavefront analyzer is considered to be nearly 100 times more accurate than measuring your vision with lenses, as has been the standard in the past. 

Most importantly, this wavefront data can be sent to the excimer laser to create an extremely complex and accurate wavefront-guided treatment, effectively correcting ALL of the aberrations that are present in your visual system.  This high-resolution, 3-D, custom wavefront treatment allows us to provide you with your optimal best personal vision that often exceeds that of glasses, contacts, and older Lasik surgery.  Wavefront guidance also provides a higher quality of vision, consistently superior night vision, and measurably reduces the chance for needing a laser enhancement compared to older conventional non-Wavefront guided treatments.  By analogy, it is like comparing high definition TV to standard TV – Wavefront guidance delivers superior clarity and superior quality.

Why would any patient knowingly choose to have a non-Wavefront guided treatment when Wavefront is scientifically proven to be superior?  Or, Why would a surgeon even offer a procedure that they know is inferior, less precise and has more side effects?  Those are questions you might just want to ask other laser centers when you are weighing their medical ethics and professionalism.

At Will Vision, by using the combination of IntraLase and wavefront customization, we only offer the best, safest, and most accurate advanced technology for your optimal visual outcome.  Customized Wavefront guided Intralase -- Why settle for anything less?

You also need to know that all Wavefront Guided procedures are not created equal.  The ability to measure and deliver wavefront guided excimer laser treatments accurately is complicated.  Not all laser manufacturers are able to deliver the best wavefront technology.  The following table details those critical differences. 

 

VISX Star S4 IR

WaveLight Allegretto

Bausch and Lomb

LadarVision 4000

Nidek EC 5000

Customized Wavefront Treatments

Yes - Widest FDA approval of any laser system worldwide

Limited

Limited

Limited

No

Wavefront Resolution

Fourier algorithm offers highest resolution of wavefront error

Zernicke algorithm interpolates and smoothes data artificially

Zernicke algorithm interpolates and smoothes data artificially

Zernicke algorithm interpolates and smoothes data artificially

Zernicke algorithm interpolates and smoothes data artificially

Active 3-D Eye Tracking

Yes

No - 2-D only

No - 2-D only

No - 2-D only

No - 2-D only

Iris Registration

Yes - Centers and aligns treatment independent of pupil center migration and eye cyclorotation

No - Manual marking only - less accurate and subjective

No - Manual marking only - less accurate and subjective

No - Manual marking only - less accurate and subjective

No - Manual marking only - less accurate and subjective

Compensates for pupil migration during physiologic pupil dilation

Yes - centers and aligns treatment independent of pupil migration

No

No

No - Pharmacologic pupil dilation required for tracking creates potential for centering error

No

Requires peri-operative use of eye drops that impair healing

No

No

Yes

Yes

No

Size of Laser Beam

Small and large spot for rapid treatment and optimized to reduce thermal injury to tissue

Small spot only but very high speed reduces tissue dehydration during laser photoablation

Small spot only - slows treatment and allows for tissue dehydration during laser photoablation

Small spot only - slows treatment and allows for tissue dehydration during laser photoablation

Scanning slit

Thermal Damage to Cornea

Variable spot scanning reduces thermal effects

Higher speed and excellent beam characteristics may reduce thermal load to tissue

High speed and small spot can be prone to thermal and drying effects

High speed and small Gaussian spot prone to thermal and drying effects

Scanning slit creates heat that damages tissue

Physician choice

Largest market share in the US and growing rapidly (VISX invented laser vision correction)

Limited physician acceptance to date

Limited physician acceptance to date

Shrinking physician acceptance and numerous post market complaints at FDA (see FDA MAUDE database) LV6000 is currently recalled by the FDA

Shrinking physician acceptance due to aging platform

Safety in conservation of corneal tissue

Conservative leaving good residual for strength

Conservative leaving good residual for strength

Aggressive system that is often tissue "hungry"

Aggressive system that is often tissue "hungry" for custom

Conservative leaving good residual for strength

Enhancement Rate

Low - Typically less than 5%

Low - Typically less than 5%

Insufficient Data Available for Comparison

Many centers report high rates of retreatments from overcorrection

Higher reported rates due to aging platform