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Wavefront-LASIK (Custom LASIK)


The most modern laser technique available is custom LASIK. The unique optical properties of your eye are used to create custom LASIK laser treatments. Until today, the adjustments for glasses, contacts, and traditional LASIK surgery were quite comparable for each kind of prescription. Custom LASIK entails measuring the eye from front to back with a specific laser and creating a three-dimensional (3-D) picture of the eye using "wavefront" technology. The wavefront-map information instructs the laser on how to tailor the therapy to your specific visual system.

Benefits of custom LASIK


Custom LASIK wavefront technology is groundbreaking because it has the ability to increase not just the amount of your vision (as measured by the traditional 20/20 Snellen eye chart), but also the quality of your vision (i.e. visual acuity measured in terms of contrast sensitivity and fine vision). This might mean a lower likelihood of unfavorable side effects after LASIK, such as night vision problems.The amount of light you perceive is determined by your lower-order and higher-order aberrations; lower-order aberrations are also known as refractive errors (i.e nearsightedness, farsightedness and astigmatism). Lower-order aberrations are treated with traditional LASIK. Higher-order aberrations are anomalies other than refractive errors that can cause difficulties such as diminished contrast sensitivity or night vision, glare, shadows, and halos. Vision is not always harmed by higher-order abnormalities. Both lower- and higher-order aberrations can be treated with custom LASIK. The following are some of the possible benefits of wavefront LASIK:

   Greater chance of achieving 20/20 vision without glasses 

    Greater chance of achieving better than 20/20 vision 

    Greater reduction in the chance of losing best-spectacle corrected vision

    Greater reduction in the chance of losing visual quality or contrast sensitivity 

    Greater reduction in the chance of night-vision disturbances

    The potential to use wavefront-LASIK to treat eyes that have previously had laser surgery and suffer from untoward side-effects (Off-label use of technology)


Visx CustomVue WaveScan


Wavefront-guided excimer laser technology


The Visx Wavescan system was the first laser to be certified by the US Food and Drug Administration for the treatment of astigmatism and nearsightedness. The Star S4 laser and the WaveScan wavefront instrument make up the VISX WaveScan system. "CustomVue" is the name given to the company's personalized LASIK process. The FDA has given its approval to eyes with up to -11 diopters of myopia and up to -3 diopters of astigmatism. Surgeons can now evaluate and treat previously undetectable visual abnormalities for the first time.


In the U.S. FDA clinical trials, 94% of patients who had the Visx CustomVue procedure achieved 20/20 or better vision. The trial participants were four times more likely to say they were "very satisfied" with their night vision following CustomVue than they were with their night vision with their glasses or contacts.

How custom LASIK works


The surgeon will begin by using the wavefront device to transmit a safe ray of light into your eye. The light is then reflected back off the posterior portion of the eye, out through the pupil, and into the abberometry device. The reflected wave of light is received and arranged into a unique pattern that measures both lower- and higher-order aberrations.


All of these visual measurements are then displayed as a 3-D map, referred to as a wavefront map. This information is then electronically transferred to the laser, and computer-matched to the eye's position, enabling the surgeon to customize the LASIK procedure to your unique visual requirements.

Getting custom LASIK


Like conventional LASIK, custom LASIK is a surgical procedure and has risks associated with it. It's important to discuss its applications and potential complications with your eye doctor to determine if you are a good candidate for this procedure.


View an article on Custom LASIK in the Stanford Report, and read more about Custom LASIK at the official VISX website for this procedure.