What is the difference between Wavefront Optimised vs Wavefront Guided LASIK?

Doctor's Answer

To answer this question, we need to start from basics.

What is a wavefront? According to Wikipedia: In physics, a wavefront is the 'locus of points characterized by propagation of positions of identical phase'.

If you throw a stone into a pool of water, you will see ripples spreading out, and each ripple can be considered a 'wavefront'. This effect can be applied to all kinds of waves, including light waves.

With regard to optics and eyesight, a good image is captured (by a sensor such as film, a chip, the retina) when a wavefront of light entering the camera/eye is focused as perfectly as possible ie with as few wavefront 'aberrations'/irregularities as possible. Wavefront aberrations can be

1. Low order (such as shortsight/longsight/astigmatism) or

2. High order (such as spherical aberration, coma, trefoil, etc)

Refractive surgeries such as LASIK can induce high order aberrations. Older generations of LASIK machines tended to induce spherical aberrations, so measures were instituted to reduce this. 'Wavefront Optimised' is a term used by Wavelight/Alcon systems to denote laser algorithms/programs where the induction of spherical aberration is minimised. It is still a 'standard' treatment, ie it does not attempt to smoothen out any pre-existing irregularities in a particular patient.

All of our eyes have pre-existing tiny imperfections in focusing that are already causing certain amounts of wavefront aberrations naturally. These are unique to the particular individual.

So 'Wavefront Guided' treatments attempt to correct our naturally pre-existing wavefront aberrations, and can be considered customised treatments.

To recap, 'Wavefront Optimized' treatments are 'standard' treatments, which make no attempt to correct pre-existing aberrations in a particular eye.

'Wavefront Guided' treatments are 'customized' treatments, which attempt to correct pre-existing aberrations in a particular eye.

It is not quite accurate to issue a blanket statement to say that one or the other treatment is better.

In my practice, I sometimes perform 'Wavefront Optimised' and sometimes 'Wavefront Guided' treatments. For example, some eyes naturally have few aberrations. With some other eyes it is not possible to get good wavefront measurements. These eyes would do better with Wavefront Optimised treatments. The other kinds of eyes may benefit from Wavefront Guided treatments, which would potentially give better, sharper vision especially at night when compared to the Wavefront Optimised treatments.

Why not do 'Wavefront Guided' treatments for everybody, you might ask? There are many possible reasons, including Wavefront Guided treatments using slightly more corneal tissue, and the fact that using an inaccurate wavefront measurement can cause a wrong treatment and induce even more aberrations.

Perhaps you may see now that the issue is a bit more complicated than it first seems.

It is probably more important that you consult with an experienced surgeon, who can offer various methods of treatment and customize an approach that is best for your particular situation.

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox