How To Decide If Wavefront Lasik Eye Surgery Is Worth The Extra Cost
By Darrell Van Zyl
Wavefront technology is not only used in wavefront eye surgery itself, but also in the initial diagnosis. This diagnosis produces a 3-D map that can be used to guide the laser extremely accurately when the actual surgery is carried out.

Studies that compare wavefront-guided to conventional have shown that a higher percentage of those undergoing wavefront guided eye surgery achieve 20/20 vision without the aid of glasses or contact lenses compared to those treated without the assistance of wavefront technology.

And perhaps just as important, with wavefront technology there is less chance of suffering from problems such as a loss of visual quality, a loss of contrast sensitivity and problems connected with night vision.

All eyes have some sort of imperfection, called an aberration. It is the degree of aberration that matters.

Lower-order aberrations are the ones you hear about most often - myopia (nearsightedness), hyperopia (farsightedness) and astigmatism.

There are also higher-order aberrations, which account for about 15% of eye problems, and have exotic names such as coma, spherical aberration and trefoil. These aberrations cause problems that can include difficulty seeing at night, halos, issues with glare and blurred vision, and account for about 15% of eye problems.

Simply put, lower order aberration determine how much you see, while higher order aberrations determine how well you see.

Unfortunately, ordinary surgery increases the chance of higher order aberrations. With wavefront eye surgery, however, while higher order aberrations still increase they do so to a lesser degree than with conventional lasik.

What is Wavefront Technology?

Wavefront technology is a system that collects information about the eye from hundreds of separate points over the central 6 millimetre area of the cornea. This creates a unique

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“map” that is specific to the eye being measured.

This information can then be linked to the laser to enable a completely customised and very accurate surgical procedure.

A further advantage is that wavefront can help identify patients who are not good candidates for surgery. surgery is certainly not for everyone; it can in fact worsen existing visual problems, so the initial diagnosis is crucial.

What is a wavefront?

Wavefront technology has been used by astronomers for many years, but the first wavefront mapping of the eye was done in 1994. Towards the end of 2002 the Food & Drug Administration approved the Custom Cornea Wavefront Lasik.

In essence, a bundle of light rays enters the eye. When the light enters the cornea, the very front of those light rays is perfectly flat - like a sheet of paper. In a perfect eye, the light will be reflected back and exit still flat.

But of course, the light passes through an imperfect crystalline lens and so is distorted when it emerges. It is this distortion that creates the "map" that tells the specialist what problems exist within the eye, how they can best be corrected, and provides the information is used to create the prescription that will be used to reshape the cornea.

How is Wavefront Technology Used?

When an eye specialist uses a conventional instrument called a phoropter, he changes the lenses and then asks the patient which lens produces the best image. This process is subject to subjective feedback (what the patient thinks he is seeing as opposed to what he is really seeing) and can only detect two eye abnormalities, these being cylindrical and spherical.

The cylindrical one causes astigmatism, while a spherical abnormality results in myopia (nearsightedness) or hyperopia (farsightedness).

Wavefront technology, on the other hand, is much more accurate, measures many more points, and can detect an infinite number of aberrations.

There are limitation to the use of wavefront eye surgery. If you are too myopic or too hyperopic, or have too much astigmatism, you will probably not be a candidate.

Thin corneas will be a problem, while having abnormally-large pupils may increase the risk of ending up with poor vision at night.

There is also the issue of cost. Most, if not all, doctors charge more for wavefront eye surgery than for conventional. As a rough guide, expect to pay about $3000 and up per eye.

In summary - wavefront technology offers precise and individualized prescriptions for eye surgery patients. If you meet the requirements, it also offers an increased probability that the resultant wavefront eye surgery will provide a successful outcome with fewer side effects.

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