Homepage / Ophthalmology or Eye Surgery / Wave Front guided custom Lasik
Wavefront-guided LASIK is a promising new technology that provides an advanced method for measuring optical distortions in the eye. Measuring and treating these distortions goes beyond nearsighted, farsighted, and astigmatism determinations that have been used for centuries. As a result, physicians can now customize the LASIK procedure according to each individual patient’s unique vision correction needs. The treatment is unique to each eye, just as a fingerprint is unique. Wavefront systems work by measuring how light is distorted as it passes into the eye and then is reflected back. This creates an optical map of the eye, highlighting individual imperfections
Make an Enquiry | Treatment Description
Description of Wave Front guided custom Lasik
Wavefront technology functions as a roadmap for LASIK surgery, providing benefits to the patient during both the evaluation and treatment process.
- During the patient evaluation process, wavefront provides the physician comprehensive individual diagnostic information, not available using earlier technologies. Thus, before surgery even begins, the surgeon is better able to determine the appropriate course of treatment.
- During treatment, wavefront allows the surgeon to tailor the laser beam settings, making the surgical procedure itself more precise. In this way, wavefront technology offers the patients sharper, crisper, better quality vision, as well as a reduction in nighttime vision difficulties, such as halos and glare.
Wavefront technology is an adjunct tool used to enhance an already safe and effective procedure. As the most common form of vision correction surgery, LASIK has already benefited millions of patients. The increased safety and the improved quality of vision benefits of customized procedures are an important technological advancement for patients and physicians alike.
Visual Errors
For purposes of this discussion, there are two categories of visual errors or “aberrations:” second-order and higher-order.
Conventional forms of optical correction have been limited to measuring the best spherical and cylindrical visual errors (second-order aberrations), which result in myopia (shortsightedness) or hyperopia (farsightedness) and regular astigmatism (blurriness), and prescribing shperocylindrical lenses in the form of spectacles, contact lenses, and conventional refractive (LASIK) surgery to correct them. Correcting second-order aberrations has the highest impact on acuity, which is the eye’s ability to distinguish object details and shape. At the same time that conventional refractive surgery corrects major, second-order spherical errors, in many cases, it also induces some degree of minor spherical aberrations.
However, about 17 percent of optical errors are higher-order aberrations. If these are minimized, image contrast and special detail are increased. Minimizing higher-order aberrations with wavefront technology by reducing the naturally occurring ones is achievable and may be particularly beneficial to individuals with unusually large amounts of higher-order aberrations.
How Wavefront Works: The wavefront aberrometer
Light can be thought of as traveling in a series of flat sheets, known as wavefronts. To clarify the confusion about light traveling as waves instead of rays, waves are just perpendicular to light rays. These light waves are wrinkled or distorted as they pass through imperfections in the eye. These errors can be displayed on a color map of the wavefront image, which is the tool that is used to diagnose, and then determine corrections, for abberrations in the eye.
There are several ways of analyzing the optical system of the eye using wavefront technology. The most common, the Hartmann-Shack wavefront sensing method, deals with light waves as they exit the eye. In this system, the surgeon or other professional shines a small, low-intensity laser into the eye, and the patient focuses on the light. As that light scatters off of the retina (the rear-most portion of the eye) it passes through the lens, the rear surface of the cornea (the clear, crystalline front part of the eye) and the front surface of the cornea. Thus, the emerging waves of light are distorted by the imperfections in the total visual system of the eye. After leaving the eye, the light passes through an array of many small lenses in the sensing device (called an aberrometer), and is focused into spots, which are recorded by a special camera. The deviation of the spots from their ideal location provides information about focusing imperfections in the visual system.
Wavefront-Guided Treatment
The goal of wavefront-guided laser treatment is to make corrections in the surface of the cornea that compensate for errors in the total visual system. Thus, the amount of wrinkle or error in the wavefront reflected from the back of the eye, as compared to the reference wavefront that was projected into it, defines the compensating optical correction. If the wavefront is retarded in relation to the reference wavefront, the laser must remove more tissue from the part of cornea related to that pattern. If the wavefront is advanced (in front of the referenced wavefront), the laser must remove less tissue. It should be noted that wavefront treatment does induce some minor second-order spherical errors, but to a significantly lesser extent than conventional refractive surgery.
In this way, a wavefront-guided treatment is customized to the characteristics of each eye and intended to minimize higher-order aberrations so that the greatest quality of vision can be achieved.
Wavefront technology is relatively new to the United States. The U.S. Food and Drug Administration (FDA) issued its first approval of a wavefront system in August 2002, and other major US laser manufacturers are expected to receive their approvals in 2003. As the FDA approves systems and they become widely available, patients will have greater access to wavefront technology and treatment.
Medical Facts
How You Will Feel:
Visual Recovery
Most patients notice an improvement in their vision immediately after completion of their surgery. By the next day vision is often dramatically improved. However, patients should understand that, while fast visual recovery characterizes the operation, it can take several months before some patients achieve their final vision after LASIK. Several studies1-2 demonstrate that the vision of a number of patients continued to improve up to six months post-operatively. During that time, patients may experience slight fluctuations in vision throughout the day. These symptoms generally diminish with time.
Crispness of Vision
For some patients, vision after LASIK matches the sharpness of vision they had with glasses or contact lenses before LASIK. However, many patients notice that 20/20 vision after LASIK can be different from 20/20 vision with contact lenses before LASIK, especially gas permeable contact lenses. The images seen through eyes treated by LASIK are often described as not being as "crisp" as those seen through glasses. This condition, referred to in ophthalmic literature as "loss of contrast sensitivity," may not affect your acuity as it is measured on an eye chart, but it can be noticeable in your daily life as a slight loss of sharpness.
The majority of patients do adjust to this change; however some do have difficulty in the first few months following surgery. Fortunately, these symptoms often dissipate within the first six months of surgery. Several published scientific papers have measured patients' pre-operative and post-operative contrast sensitivity, and nearly all have reported that it returns to pre-operative levels within the first six months.3-7
Dry Eyes
Some patients experience dry eyes post-operatively. The symptoms can vary widely - from being relatively asymptomatic, to intermittent dryness at certain times during the day, to feeling the typical dry sensation much or all of the day, sometimes accompanies by blurry vision or an increase in glare and halos. When the dry eye is treated, those symptoms diminish.
Clinical dry eye is comparatively easy to diagnose and the great majority of patients respond well to treatment options ranging from use of preservative-free eye drops to insertion of punctal plugs, depending on the severity of the case. For almost all patients, dry eye symptoms gradually subside over the first few weeks or months after LASIK surgery. If you suspect that you may have post-operative dry eye, you should contact your doctor's office for an evaluation.
Glare/Halos/Starbursts
Many LASIK patients notice a temporary decreased in night vision with symptoms that include glare, halos, and starbursts. The experience of the phenomena can range from mild to severe. We provide detailed information regarding the incidence of these symptoms in our Quality of Vision section.
These symptoms usually subside within by six weeks or so for the vast majority of patients who experience them. However, some will continue to experience them for a greater length of time.
There are several potential causes of decreased night vision. The most common is the normal mild swelling of the LASIK flap, which resolves within a few weeks of surgery. Many researchers believe that patients who have pupils that exceed the ablation zone may be more likely to experience decreased night or low-light vision following LASIK than the general population. Another cause is incomplete correction of the nearsightedness, farsightedness or astigmatism. Clinical dry eye can also contribute to the experience of glare and halos. Rarely the cause is mild irregularities that the LASIK surgery produces in the shape of the cornea.
Depending upon the cause, those patients who experience significant, persistent glare, halos or starbursts have several treatment options. Enhancement procedures may be an option, but not everyone is eligible for an additional procedure. Eligibility for enhancements depends on a number of factors that a doctor must evaluate. For some patients, prescription eye drops to prevent dilation of the pupil at night to reduce the symptoms of decreased night vision may be an option. However, this pharmaceutical approach is not successful for all people, and it also can represent a significant expense over time. Diagnosis and treatment of clinical dry eye may alleviate many of the symptoms. Toric contact lenses may be prescribed for those who have astigmatism. Future advances in laser technology offer great promise.
Overcorrection, Undercorrection & Regression
Nearsighted patients who experience an overcorrection will become farsighted and will notice immediately that they can no longer see near objects as well. Conversely those who have been undercorrected will notice that objects in a distance are still not perfectly clear.
Farsighted patients who experience an overcorrection will become nearsighted and will notice immediately that they can no longer see objects at a distance clearly. Those who have been undercorrected will notice that near objects are still not totally in focus.
If an over or undercorrection has occurred, the ophthalmologist will discuss your treatment options. Generally, surgeons prefer to wait approximately 3-6 months to perform an enhancement to ensure that the final vision has been achieved. As that point, either a hyperopia or myopia LASIK procedure will be performed to correct the residual error, if the patient and doctor believe it is appropriate.
Conventionally, regression is defined as a shift in initial visual outcome. In this situation, the sharpness of vision that occurs soon after surgery diminishes as the eye regains a small amount of its original nearsightedness, farsightedness, or astigmatism. Regression can occur quickly, within the first few weeks after surgery, but it also can occur slowly over time. Patients who experience regression will notice their vision changing progressively (not a fluctuation during the day). Typically, the ophthalmologist will evaluate the regression to determine its cause and review treatment options with the patient. Typically, an enhancement procedure can be performed to correct the residual error, just as is done to treat an undercorrection or overcorrection.
DLK
As we mention in our Risk & Complications section, diffuse lamellar keratitis (DLK) is a unique and relatively rare post-operative condition following LASIK. Non-severe forms have been estimated in 1% of cases; severe cases comprise only about 1 in 5,000 surgeries.8
Patients should understand that at the early stages of the condition, they most likely will not experience symptoms they would be able to discern, and only upon examination by a doctor could this condition be detected. When caught early, the inflammation associated with DLK is easy to treat. Patients should be aware, however, that while approximately 80% of the condition will clear up within the first 24 to 48 hours, it could take several weeks until the condition completely subsides.
We emphasize that this condition can be treated without significant visual loss when it is detected and treated early. Therefore it is imperative that all patients maintain their surgeon's recommended post-operative follow-up examination schedule.
Patients should carefully review their immediate post-operative expectations with their ophthalmologist prior to the surgery. They should discuss the follow up schedule and all post-surgical instructions. Then, if you notice something about your vision that deviates from your doctor's expectations, you should notify his/her office immediately.
How Long Will you stay in Hospital after your Wave Front guided custom Lasik?
Single Day In-patient Care
What to do next:
We specialise in providing medical care and surgery abroad. We only work with medical institutions that we have inspected and checked. We offer Wave Front guided custom Lasik
in both North and South India as well as facilitation on all the other elements in your journey such as flights, accommodation and activities. Our team in India operate as your personal agents while you are in country and is tasked with supporting you in any way you need.
We work with hospitals across the world including France, UK, Canada, India, Pakistan, Malta and Hungary to provide our patients with the most appropriate levels of care and treatment
Click here for our estimated prices for most common surgical procedures around the world. .
We have teams in the UK, India and Pakistan who manage your stay and provide you with support whenever you need it. Please contact us to find out how we can help you. Contact us even if you are at the early stages of considering the possibility of treatment abroad.
Why Travel for Wave Front guided custom Lasik .
Travelling abroad for Wave Front guided custom Lasik can give you access to top quality health care quickly and cheaply. Our mission is to make your journey absolutely successful - in terms of treatment, in terms of outcomes and in terms of experience. We offer treatment in a wide range of locations including Europe, India and Singapore.
Make an Enquiry to Globe for Wave Front guided custom Lasik
Please feel free to post an enquiry to us at Globe if you are interested in having more details of how this all works and how we might be able to help you. Your information is treated as strictly confidential by us. We ask that you fill in the fields with the red stripes if possible. You can also contact us directly with details from our contact us page.
If you want to speed up the process or have a complex history that is specifically relevant to any further steps: please use our detailed medical questionnaire which includes a range of questions to capture details of your medical history and present condition. Please note that we share these details anonymously with clinical specialists for the purposes of considering your case and advising on a treatment plan. This means that we do not pass on your name or address details until you choose to proceed further with us.
