Wavefront-Optimized LASIK

What is Wavefront-Optimized LASIK?

Wavefront-optimized LASIK is similar to conventional LASIK but with some enhancements. Both procedures treat your refractive error, which corresponds to the numbers on your eyeglass prescription. However, wavefront-optimized LASIK delivers better quality vision. 

One concern with conventional LASIK is that some patients experience light-related distortions after surgery. These side effects occur because the laser flattens your cornea, which is the clear covering in front of your eye. We call these distortions higher-order aberrations.

Higher-order aberrations cause symptoms like:

  • Halos or starbursts around lights
  • Glare
  • Ghosting or shadows in your vision
  • Reduced contrast sensitivity
  • Difficulty seeing in low light conditions

On the other hand, your refractive error is an example of a lower-order aberration.

Different types of refractive error include:

Wavefront-optimized surgery prevents higher-order aberrations better than conventional LASIK. This means clearer vision, particularly at night. 

What is a wavefront?

If you imagine multiple rays of light, the wavefront is a surface perpendicular to corresponding points on each of these light rays. 

Wavefront-Optimized LASIK Procedure Overview

  1. Before surgery, your eye doctor will check your prescription, which is called a subjective refraction. You may be familiar with this part of the eye exam when you must choose which lens looks clearer. 
  1. The laser will use your prescription as the basis for your LASIK treatment, just like conventional LASIK.
  1. The laser also uses special wavefront software. The program directs the laser to treat not just the center, but also the periphery of your cornea. This allows your cornea to maintain its natural shape, which minimizes any postoperative higher-order aberrations.

Conventional LASIK flattens your cornea, which can cause glare, halos, and difficulty seeing at night. Wavefront-optimized LASIK maintains the natural curve of your cornea, creating fewer side effects.

How Much Does Wavefront-Optimized LASIK Cost?

Wavefront-optimized LASIK may cost slightly more than conventional LASIK. However, wavefront-optimized procedures may cost less than more advanced types of LASIK, such as wavefront-guided or topography-guided LASIK.

If your surgeon combines wavefront-optimized LASIK with a bladeless LASIK procedure, this can increase the cost further. LASIK typically ranges between $4,000 to $5,000 for both eyes. A conventional, non-bladeless LASIK procedure may cost less. 

Advantages and Disadvantages of Wavefront-Optimized LASIK

Advantages

  • Higher-quality vision. Wavefront-optimized LASIK gives you sharper vision versus conventional LASIK. Because wavefront-optimized procedures create fewer higher-order aberrations, patients experience less night vision problems.
  • Wide range of treatment. Diopters (D) are the units used to measure your eyeglass prescription. Wavefront-optimized LASIK is approved to treat up to 12.0 D of myopia, 6.0 D of astigmatism, and 6.0 D of hyperopia. This range is wider than other customized LASIK treatments.
  • A great alternative to other customized LASIK treatments. With other customized procedures, like wavefront-guided and topography-guided LASIK, obtaining reliable measurements is more complicated. Unreliable measurements can happen for a variety of reasons, including eyelid interference, poor eye alignment, or dry eyes. In these situations, the surgeon may perform wavefront-optimized LASIK instead.

Disadvantages

  • Does not correct pre-existing corneal irregularities. Wavefront-optimized surgery mainly prevents higher-order aberrations that occur during the procedure but does not treat pre-existing aberrations. If you have irregular corneas, wavefront-guided LASIK may be more suitable for you.
  • May not suit post-cataract surgery patients. Occasionally, patients who receive cataract surgery need LASIK to correct any residual prescription. Depending on the type of lens implant the patient selected for the cataract surgery, wavefront technology may not produce high-quality measurements. The surgeon may perform conventional LASIK in these cases.

Icon of a person versus another person

Wavefront-Guided LASIK Versus Wavefront-Optimized LASIK

Though the names are similar, wavefront-guided and wavefront-optimized are two different LASIK procedures. 

Just like conventional LASIK, wavefront-optimized LASIK relies mainly on your eyeglass prescription to correct your vision. However, wavefront-optimized surgery uses advanced computer software to deliver higher-quality vision compared to conventional LASIK. 

Wavefront-guided technology is more sophisticated. This procedure uses a wavefront aberrometer, which is a special instrument that creates a 3D map of your cornea. This map allows the surgeon to give you a highly customized treatment.

Here are some important points to know about wavefront-guided and wavefront-optimized LASIK:

  • Wavefront-guided and wavefront-optimized LASIK both use advanced software, which guides the laser to reshape the periphery of your cornea. Doing so helps to minimize post-surgical aberrations.
  • Studies find most patients have minimal amounts of higher-order aberrations, especially at a younger age. These patients would benefit from either a wavefront-guided or wavefront-optimized procedure.
  • If a patient does have pre-existing higher-order aberrations, wavefront-guided LASIK is the better option. 
  • You can think of wavefront-guided LASIK as minimizing pre- and post-surgical aberrations, while wavefront-optimized LASIK mainly prevents post-surgical aberrations.
  • Wavefront-optimized procedures are faster than wavefront-optimized LASIK.

Overall, research shows both types of LASIK deliver excellent visual outcomes. However, wavefront-guided LASIK generally yields better visual results, with fewer aberrations post-surgically.

Author: Melody Huang, O.D. | UPDATED April 21, 2020

Resources

Machat, Jeffery J. “Evolution of the Wavefront-Guided Laser.” Cataract & Refractive Surgery Today, May 2015, www.crstoday.com/articles/2015-may/evolution-of-the-wavefront-guided-laser/.

McCabe, Cathleen M. “PRK Versus LASIK After Cataract Surgery.” Cataract & Refractive Surgery Today, July 2016, www.crstoday.com/articles/2016-jul/prk-versus-lasik-after-cataract-surgery/.

Moshirfar, Majid, et al. “Meta-Analysis of the FDA Reports on Patient-Reported Outcomes Using the Three Latest Platforms for LASIK.” Journal of Refractive Surgery, vol. 33, no. 6, 1 June 2017, pp. 362–368, doi:10.3928/1081597x-20161221-02. 

Perez-Straziota, Claudia E., et al. “Visual Acuity and Higher-Order Aberrations with Wavefront-Guided and Wavefront-Optimized Laser in Situ Keratomileusis.” Journal of Cataract & Refractive Surgery, vol. 36, no. 3, Mar. 2010, pp. 437–441., doi:10.1016/j.jcrs.2009.09.031.

Roe, Joshua R., and Edward E. Manche. “Prospective, Randomized, Contralateral Eye Comparison of Wavefront-Guided and Wavefront-Optimized Laser in Situ Keratomileusis.” American Journal of Ophthalmology, vol. 207, 4 June 2019, pp. 175–183, doi:10.1016/j.ajo.2019.05.026.

Stephenson, Michelle. “Wavefront-Guided VS. Wavefront-Optimized Laser Treatments.” EyeWorld Online, ASCRS Ophthalmic Services, 30 June 2017, www.eyeworld.org/wavefront-guided-vs-wavefront-optimized-laser-treatments.

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