CustomCornea® / CustomVue® / Ladarwave® Wavefront-Guided Laser
For years, excimer lasers have been used for LASIK, PRK and LASEK to correct “lower order” abnormalities (aberrations) such as nearsightedness, farsightedness and astigmatism. Over 6 million people have been treated worldwide with “conventional LASIK” and over 98% of these patients are now seeing 20/20 to 20/40 without glasses. With such impressive results, how could you expect laser vision correction to improve? --- Because other visual distortions, called “higher order aberrations”, can be responsible for decreasing the overall quality of your vision. These imperfections in your eye’s optical system may affect the clarity of your vision and how well you see at night or in low light. Higher order aberrations are more apparent when the pupil is large and can cause glare, halos and other unpleasant visual effects. Unless these higher order aberrations are addressed, the quality of your vision after your laser treatment may not be ideal, even if you have measurable vision of 20/20 in the exam room.
Traditionally, we have only been able to measure lower order aberrations, and then correct these aberrations with glasses or contact lenses. Conventional LASIK attempts to replicate the vision obtainable with the best glasses and contact lenses. To date, the results with conventional LASIK have been excellent. 
However, we know that the eye is not perfectly regular and each spot on the eye actually requires its “own” particular prescription. This is clearly impossible with glasses, contact lenses, or conventional LASIK. With Wavefront-guided laser hundreds of individual locations are measured, and each microscopic area is treated in order to attempt to maximize vision.
(Illustration of the laser treating individual spots)
Wavefront-guided laser is possible due to the invention of a sophisticated diagnostic device called an “aberrometer”. This instrument has been adapted from technology first used for specialized telescopes. It was developed to correct distortions in light waves from space allowing researchers to accurately view images of stars and planets. The wavefront device in our laser centers uses the same technology to measure light waves as they travel through your eye. This technology provides a precise and more detailed analysis of your vision. As the light waves travel through your eye’s optical system, the distortions in your vision are measured. The device captures the distorted waves as they exit your eye and mathematically
compares them to a plane of flat light waves that would have been reflected if your optical system were perfect. Next, a 3D map is generated representing your unique visual distortions, including both lower and higher order aberrations. This map serves as a guide for the laser, telling it how and where to reshape the cornea to correct your specific personal visual abnormalities.
Shown to the right is the wavefront map.
Different colors depict visual distortions.
Patients who have few higher order aberrations are generally very happy with their results using traditional LASIK. However, traditional LASIK, PRK and LASEK even if perfectly performed can induce higher order aberrations from the treatment itself. Thus, Wavefront-guided laser can be utilized to try to achieve a more optimal result for patients with or without pre-existing higher order aberrations by tailoring treatment to one’s personal optical system. Because the treatment is much more customized than with glasses, contact lenses, or conventional LASIK methods, the level of vision obtained may be more precise and the quality of vision sharper. However, it is important to realize that results will vary from patient to patient depending upon how each individual eye heals. Although the FDA studies and clinical experience have shown that many patients achieve superior quality of vision following Wavefront-guided laser compared to glasses or contact lenses, it is impossible to predict which patients will benefit even if pre-existing higher order aberrations are present. There can be no guarantee that Wavefront-guided laser will be any better than conventional laser treatment in any given individual. However, Wavefront-guided laser offers the very latest in technology and the greatest chance to achieve the best possible vision.