Monthly Archives: January 2011

Why choose CustomVue Wavefront PRK or Epi-LASIK

By | Customvue, Epi-lasik, Laser vision correction, LASIK, PRK, Refractive Surgery, VISX | No Comments

There are a number of things to consider when deciding whether or not to have laser vision correction and where to have it done.

It can be helpful to have more than one refractive assessment to meet staff, see the facility, and learn about the services offered at that center.  Most importantly a thorough refractive assessment will determine if laser vision correction is safe for you.  There are many factors that are considered during an assessment including corneal thickness, corneal shape, how high your correction is, and general medical and eye health issues.  More information about these factors can be found in Dr. Anderson Penno’s book Laser Vision Correction: What You Need To Know  available at: http://www.amazon.com/Laser-Vision-Correction-What-Need/dp/143926497X/ref=sr_1_4?s=books&ie=UTF8&qid=1296107050&sr=1-4

It is important to choose a surgeon you are comfortable with and a procedure that is right for you.  When choosing a procedure the laser vision correction options fall into flap and no-flap categories.  Flap procedures include Intra-LASIK (called I-LASIKby AMO)  and LASIK.  These treatments both involve the creation of a corneal flap and carry a higher risk than surface treatments.  No-flap surface treatments include PRK, Epi-LASIK, and LASEK.  For surface treatments the epithelium layer is removed and the laser is applied to the surface of the cornea.  Many refractive surgeons believe that a wavefront treatment will be most effective if used in combination with a surface laser vision correction rather than a flap treatment.  The reason is that the corneal flap created by LASIK or Intra-LASIK may induce additional vision abberations that may diminish the benefit of a wavefront treatment.

Wavefront laser vision correction involves measuring the higher order aberrations that are individual to each eye and then using that data to create an individualized laser vision correction.  The analogy that is often used is that for nearsighted eyes the cornea is shaped like a basketball that is too steep, for farsighted eyes the basketball is too flat, and in astigmatism the cornea is shaped like a football.  A standard laser vision correction will reshape the cornea into a sphere (basketball) that is just right.  Wavefront treatments will then smooth out any imperfections that may be present on the surface to produce maximum vision results.

There are many studies that indicate the benefits of wavefront treatment in maximizing uncorrected vision.  Due to the number of different laser manufacturers, variety of treatments (flap, no-flap, etc.), surgeon differences, and individual healing responses it is difficult to make an exact quantification of the benefits of wavefront treatments compared to standard laser ablation or between wavefront capable lasers.  Reliable scientific studies can be found in peer reviewed studies such as those available at the US National Library of Science online database:http://www.ncbi.nlm.nih.gov/pubmed  TheVISX S4 IR Customvue system is the most widely used custom wavefront system used in North America.  It has benefits of iris recognition and cyclotorsion (rotational) adjustment that enhances accuracy.  It also features a variable repetition rate and variable spot size which reduces heat generation and allows for a very refined corneal reshaping capability.

Wavefront custom laser vision correction can enhance visual results and is one of the factors that should be considered when deciding whether to have laser vision correction and where to have it.  For more information or to book a refractive consultation with Dr. Anderson Penno, contact Western Laser Eye Associates.