Custom LASIK and PRK/ASA
Wavefront technology, which was the first FDA-approved corneal mapping technology used in LASIK, PRK, or ASA involves the use of advanced technologies for assessing and correcting the unique optical imperfections of an individual's eye. Unlike conventional laser vision correction surgery, wavefront technology uses a special laser to make specialized measurement of your eye's optics, which provides distinct information that is used to precisely program the laser used in laser vision correction surgery treatment (such as LASIK, PRK or ASA )to reshape your cornea.
By capturing detailed data about the eye's aberrations and irregularities, Wavefront technology creates a personalized map of the eye's optical pathway. This map guides the laser used to reshape your cornea during LASIK, PRK, and ASA surgery. The result is a more accurate and tailored vision correction that addresses not only standard refractive errors (like nearsightedness, farsightedness, and astigmatism) but also higher-order aberrations that can impact visual quality, such as glare and halos.
Fun fact: The basis of Wavefront testing is from the field of adaptive optics, which was used for years by astronomers to build better lens systems for improving the optics of telescopes.
The use of Wavefront technology and Corneal Topography for laser vision correction surgery goes beyond conventional approaches by capturing and utilizing distinct information about your eye's optics, leading to enhanced precision and improved outcomes in these laser vision correction procedures.
Custom LASIK and PRK as well as ASA laser vision correction procedures can help correct vision problems due to:
- Nearsightedness
- Farsightedness
- Astigmatism
- Presbyopia (Monovision or blended vision where only one eye is corrected for distance)
Please click on the arrow on the video below to see how Wavefront technology is used with LASIK.
Custom LASIK and PRK- Introduction
Custom LASIK and PRK utilizes advanced technologies and offer several advantages over traditional LASIK and PRK procedures. ASA is another laser vision correction procedure that may be a better option than LASIK for patients who have active lifestyles, dry eyes, or thin corneas.
There are three variations of Custom LASIK that offer more precision which can help you attain your best possible vision while while avoiding if not reducing side potential higher order aberrations (side effects like halos and glare).
- Wavefront Guided LASIK. Wavefront-guided LASIK and PRK use measurements from a wavefront sensor to provide a more customized correction for higher-order aberrations. View video of Wavefront Guided LASIK.
- Wavefront Optimized LASIK. Wavefront-optimized LASIK PRK/ASA make measurements that prioritize maintaining the natural curvature of the cornea, while correcting refractive errors, with a focus on adapting the laser treatment to the eye's inherent shape in order to minimize the onset of higher-order aberrations. View Video of Wavefront Optimized LASIK.
- Topography Guided LASIK. Topography guided or topography assisted LASIK use corneal topography to enhance precision and reduce night-vision problems and other possible side effects. View Video of Topography Guided LASIK.
Differences Between Custom LASIK and PRK Technologies
The main differences among these “Custom” LASIK technologies lie in their approaches to addressing refractive errors and higher-order aberrations:
- Wavefront Guided. Wavefront Guided LASIK and PRK/ASA help to better correct both lower and higher-order aberrations and may be better suited for people with complex prescriptions and those with significant higher-order aberrations.
- Wavefront Optimized. Wavefront Optimized LASIK and PRK/ASA prioritize measurements that seek to maintain the cornea's natural shape while correcting lower-order aberrations and is suitable for mild to moderate prescriptions and those concerned about side effects.
- Topography Guided LASIK. Topography-guided LASIK utilizes corneal topography to address irregularities and distortions, making it suitable for patients with irregular corneas or those who have had previous refractive procedures.
Wavefront technologies have been approved by the FDA for LASIK and PRK. While Topography Guided LASIK has been approved by the FDA, it has not been approved for PRK.
The choice of which "Custom" technology is best for you depends on factors such as the complexity of your vision, your unique "fingerprint" or map of your cornea, your ocular health, and your specific visual needs. Consulting with a laser vision correction surgeon with proven expertise in these "Custom" technologies is highly recommended so you can determine the most appropriate treatment to help you see your best.
How Can Wavefront-Guided Technology Help Obtain a Better Outcome with LASIK and PRK?
The human eye has two broad categories of aberrations: lower order and higher order.
Lower order aberrations represent the patient’s prescription for glasses such as nearsightedness, farsightedness, and astigmatism.
There are numerous higher order aberrations but the two most important ones for potential LASIK, PRK and ASA patients are spherical aberration and coma. When these two aberrations are increased above preoperative levels, patients may notice more problems with the quality of their night vision and be more aware of halos, starbursts, flare, and glare.
Conventional laser eye surgery (LASIK and PRK/ASA) is excellent at reducing or eliminating the lower order aberrations and most patients obtained satisfactory uncorrected vision, usually near 20/20. However, conventional LASIK and PRK (without custom technologies) may increase the degree of higher order aberrations, which accounted for the possible increased likelihood of night vision and low light problems.
Wavefront-based laser eye surgery measures the amount of both lower and higher order aberrations. For Wavefront Guided LASIK and PRK/ASA, this information is then used by the excimer laser system for LASIK, PRK and ASA in an attempt to either reduce or at least minimize the increase of higher order aberrations that can result from laser vision correction surgery.
Custom LASIK and PRK: Like a "Fingerprint" of Your Cornea
All of the FDA-approved laser systems for LASIK, PRK and ASA now offer the use of these "Custom" Wavefront corneal mapping and measurement technologies, so that each patient’s optical system is measured more accurately than ever before, producing in effect a unique “fingerprint” of their pre-operative visual problems. Consequently, a truly customized treatment plan can be implemented in the laser eye surgery procedure for each patient.
What is Corneal Topography?
Corneal Topography is a specialized eye test that helps doctors understand the shape and health of your cornea. It works by creating colorful patterns on the cornea's surface using reflected light.
Use of Corneal Topography for LASIK. Corneal Topography helps check if your cornea is suitable for LASIK. It can also help to spot issues that may show you are not a suitable candidate for LASIK such as scars on your cornea, growths, severe curvature of your cornea (a condition known as keratakonis) or other eye problems that can affect your vision.
In simple terms, corneal topography is a valuable tool that helps eye doctors make sure your cornea is in good shape and that you get the right treatment if there's a problem. It's like a map of your eye's surface, ensuring you see the world clearly.
Please click on the arrow on the video below to learn more about Corneal Topography and How It Is Used for Refractive Surgery and Prescriptions for Contact Lenses.
Advanced Surfaced Ablation (ASA): A Flapless Custom Alternative
While Custom LASIK is a widely discussed option, Advanced Surface Ablation (ASA) is another significant laser vision correction procedure that benefits greatly from the same advanced custom technologies used in Custom PRK. As an advanced form of Photorefractive Keratectomy (PRK), ASA is a flapless procedure where the excimer laser reshapes the cornea's surface directly after the removal of the thin outer epithelial layer.
This makes ASA an excellent alternative for individuals who may not be ideal LASIK candidates, particularly those with thin corneas, chronic dry eyes, or active lifestyles. The personalized treatment profiles created by wavefront-guided and topography-guided systems, which you learned about above, allow surgeons to perform ASA with a high degree of precision, correcting not only nearsightedness, farsightedness, and astigmatismbut also addressing higher-order aberrations. By utilizing these custom technologies, ASA aims to provide excellent visual outcomes with the unique benefits of a surface-based procedure.
Custom LASIK, PRK and ASA Can Help You Achieve Your Best Possible Vision
This "fingerprint" or "map" of your cornea obtained through these Custom technologies for LASIK, PRK and ASA enable your laser vision correction surgeon to better program the laser to obtain better results from the laser eye surgery procedure that is best for you. By using Custom LASIK, PRK or ASA, there is a possibility that your existing higher order aberrations may not increase at all, and some patients report that they can see even better than they did with glasses or contact lenses. This is called a gain in best spectacle corrected visual acuity.
FDA studies of Wavefront-based (Guided or Optimized) LASIK, PRK and ASA and Topography-Guided LASIK have improved the chance of obtaining 20/20 vision or better and have decreased the chances of significant night vision problems.
Why Choose a LASIK Surgeon With Proven Expertise?
Because each eye is unique and will have different measurements, choosing an expert LASIK and laser vision correction surgeon is invaluable, since such a surgeon can assess your eyes and vision, and utilize the best "Custom" technology for the laser vision correction procedure most suited to helping you attain your best possible vision while minimizing higher order complications like halos and glare. The Trusted LASIK Surgeons® directory feature those surgeons who have the proven expertise: Why Choose a Trusted LASIK Surgeons®?
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Custom LASIK and PRK/ASA Frequently Asked Questions (FAQs)
Frequently Asked Questions (FAQs)
Q: What are Custom LASIK and PRK/ASA? These procedures use advanced mapping technologies like Wavefront or Topography to create a highly personalized laser treatment plan to correct vision, including higher-order aberrations.
Q: How is Custom treatment different from standard LASIK or PRK? Standard treatments correct basic prescription errors. Custom treatments use detailed eye measurements to address unique imperfections for potentially sharper vision.
Q: Which technologies are used for Custom procedures? Wavefront-Guided, Wavefront-Optimized, and Topography-Guided technologies are used to map the eye and guide the laser.
Q: Can Custom treatments be done with PRK or ASA? Yes, while some technologies were initially FDA-approved for LASIK, experienced surgeons can use Wavefront-Guided, Wavefront-Optimized, and Topography-Guided treatments with PRK and ASA based on clinical evidence, sometimes considered "off-label" use.
Q: What are the benefits of Custom vision correction? Potential benefits include sharper vision, improved night vision quality, and reduced risk of issues like glare and halos compared to conventional treatments.
Q: Are Custom technologies FDA-approved? Yes, specific Wavefront-Guided, Wavefront-Optimized, and Topography-Guided technologies are FDA-approved, primarily for use with LASIK for certain indications. Some are also approved for PRK.
Q: Who is a good candidate for Custom procedures? Many patients are candidates, especially those with complex prescriptions, irregular corneas, or concerns about night vision quality. Candidacy depends on eye health and surgeon evaluation.