FAQ

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.

Custom 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.

While custom LASIK may be very appropriate for some patients, it may not be necessary – or even appropriate – for other patients.

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.

When you read about claims that Custom 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.

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.

While we understand a great deal about the eye’s lower-order aberrations and their stability, we understand far less about its 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.

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.

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.