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Customized Lasik

Wavefront is a very old technology that has only recently been applied to human vision. Wavefront has been used for years by astronomers who need to adjust the optics of their telescopes. A reflecting mirror within the telescope that can be deformed is adjusted using wavefront data to eliminate aberrations induced by the Earth's atmosphere. In custom wavefront Lasik, PRK, LASEK, and Epi-Lasik, the excimer laser uses wavefront information to change the shape of the cornea by ablating tissue.

Wavefront Diagnosis and Wavefront Treatment

Wavefront is actually used in two separate ophthalmic events. The first is a wavefront evaluation and diagnosis of existing aberrations. The second is using what is learned from the diagnosis to create a wavefront-guided ablation for Lasik, PRK, LASEK, or Epi-Lasik.

Our organization has included wavefront diagnostic as a must-do in our 50 Tough Question For Your Doctor, but we have not included it for guided ablations. A wavefront diagnostic can determine if an individual has aberrations that would be exacerbated by refractive surgery to the point of causing vision problems. No other technology can achieve this level of diagnosis. Wavefront diagnostic can determine if a wavefront guided ablation is an absolute requirement, conventional ablation would be fine, or the patient should not have surgery at all. This is why we believe wavefront diagnostic is an important evaluation


A common eye examination and refraction evaluates low order aberrations (LOA). These are commonly called sphere (myopia, nearsighted, shortsighted or hyperopia, farsighted, longsighted) and cylinder (astigmatism). Only a wavefront diagnosis is able to measure high order aberrations (HOA), which are beyond simple sphere and cylinder. HOA are represented in mathematical calculations and are therefore infinite. The more common of these mathematical calculations are Zernike polynomials and have names like spherical aberration, coma, trefoil, and quatrefoil. Ophthalmology only deals with about the first eight levels of HOA as represented in Zernike.

Wavefront technology as a diagnostic device is unsurpassed. This technology can diagnose and measure aberrations that no other system can even see. It is important to understand that without a wavefront diagnosis, it is impossible for a doctor to accurately determine if wavefront-guided ablation is necessary for a good Lasik, PRK, or LASEK outcome. Also, without a wavefront diagnosis it is impossible for a doctor to accurately determine if a wavefront ablation is not necessary. In other words, virtually every person considering Lasik, LASEK, PRK, or Epi-Lasik should have a wavefront diagnostic evaluation.