Wavefront LASIK:  Separating Marketing Hype from Reality

Every person’s eye has its unique optical defects, known as aberrations.  These aberrations consist of those correctable by traditional lenses, such as nearsightedness or astigmatism, and other imperfections which cannot be corrected with lenses (called “higher-order” aberrations).

Newer technology now allows us to measure these higher-order aberrations.  In addition, the newer lasers have the capability to correct some of these defects.  Theoretically, one should see better when treated with Wavefront treatment.  But often this is not the case.  Many patients notice no better vision after Wavefront than they had with contacts or glasses.  And paradoxically, some patients actually have worse vision than their glasses after Wavefront treatments.

Several studies have been published comparing the vision outcomes of traditional LASIK compared with Wavefront LASIK.  Virtually all the studies show that there is no statistically significant difference in the visual outcomes between the two treatment options.  Certainly some patients do get better outcomes, but when averaged out over a large sample, wavefront treatments provide no better outcomes than conventional LASIK treatments performed using current state-of-the-art laser vision correction systems. If one reviews the wavefront approval letters for all the major laser companies posted on the FDA website, www.fda.gov, it is readily apparent that the patient sample sizes utilized in the wavefront studies are infinitesimally small when compared to the over 40 million people in the United States for which these wavefront treatments would be applicable.

Dr. Flowers has observed results similar to that of the studies.  Because of this fact, he uses Wavefront technology very selectively.  Certainly any patient who wishes to have Wavefront may elect to do so, but we do not believe in automatically performing a Wavefront treatment unless we are convinced the patient will benefit from the treatment .  Like any new technology, Wavefront has a long way to go before Dr. Flowers will feel comfortable treating every patient with it. 

Here are some interesting facts you should be aware of concerning Wavefront:

1)      The laser companies charge more for Wavefront treatments.  Hence they are motivated to market Wavefront positively so they generate more profits.

2)      Some higher-order aberrations might actually improve our vision.  For instance, some new contact lens designs actually incorporate the higher-order aberration called “spherical aberration” because it improves the clarity.  Wavefront treatments attempt to remove or reduce all aberrations from your eye.  We are still learning about “good” and “bad” optical aberrations, and thus, our knowledge pertaining to this issue is still rather limited. Consequently, a wavefront treatment could remove a good optical aberrration and thus, lead to a poorer visual outcome.

3)      In order to treat higher-order aberrations , the laser “spot” is made very small.  But the cells on the surface of the cornea are actually about twice as large as the spot the laser uses, effectively canceling out the effect of some of the higher-order treatment anyway.

4)      If you see very clearly (20/20 or 20/15) with your glasses or contacts, you probably do not have much higher-order aberration.  If you did, then you would not correct so well with traditional lenses.  If you do not correct well with regular lenses, then Wavefront might actually make a difference, and that is when we usually recommend its use.

5)      Wavefront treatment means that a computer makes all the decisions about your correction ­ the doctor’s measurements are discarded.  This takes control from the surgeon and gives it to a machine.  Sometimes this works out well, sometimes not.

6)      We use the exact same laser to do Wavefront that we use for standard treatments.  Wavefront is a refinement of existing laser technology, not a miraculous new laser device that the marketing hype would have you believe.

We do believe that Wavefront technology is a good technology when applied appropriately.  We have the most up-to-date Wavefront system available.  We also feel that Wavefront technology will continue to improve over the next five to ten years.  It is ultimately up to you  - we will gladly treat your eyes with Wavefront if you desire it.  But we will also give you our honest opinion if we think you have nothing to gain from it.