With LASIK, "Custom" is Better

If you live your life through the lens of glasses or contacts, you may be considering LASIK corrective eye surgery. LASIK brings the promise of visual clarity that your eyes were not capable of before. But there are differences in LASIK procedures, and it’s to your advantage to know how far this “miraculous” surgery has advanced in the past few years.

One breakthrough is the development of eye-mapping and laser guidance systems that “customize” the LASIK procedure. Although some clinics still offer standardized LASIK, customized LASIK offers significant advantages.

“Our eyes are as unique as our DNA or fingerprints,” says William B. Hart, M.D., an ophthalmologist at Hart Eye Center. “In fact your left eye even differs from your right eye. Each has its own individualized vision needs.”

When considering LASIK, it stands to reason that a person will gain better quality eyesight from choosing a customized surgery over a standardized procedure. Dr Hart says “With custom LASIK we can provide a unique treatment for each eye, resulting in personalized correction that is as individual as your eye.”

“Customized” and “personalized” are terms that are often overused, but custom LASIK is truly personalized to your eyes and no one else’s. You may be wondering “How is custom LASIK personalized, and how is this customization more effective?”

LASIK (laser assisted in-situ keratomileusis) is a corrective procedure utilized to repair refractive errors, which prevent the eye from focusing properly. The surgery reshapes the cornea to change and enhance its focusing power.

The cornea’s role is similar to that of the lens on a camera, as light enters the cornea, it bends and focuses; this is known as refraction. No one has a “perfectly” shaped cornea; each person’s imperfections serve as the eye’s fingerprint, unique to every individual. For many people, these tiny disfigurations affect the focusing power of the eye, which can impair vision, making objects appear blurry or “out of focus.” These problems are called refractive errors. Dr. Hart explains, “There are three primary types of refractive errors: myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. It is common to find conditions combining myopia and astigmatism or hyperopia and astigmatism.”

The surgical procedures for standardized LASIK and customized LASIK are very similar; the difference is in the approach and tools. Custom LASIK provides individualized vision correction through the use of Wavefront™-guided technology.

Wavefront™ was originally developed to aid astronomers by perfecting images taken from telescopes. In LASIK, Wavefront creates a three-dimensional map that demonstrates how individualized irregularities in the cornea affect the way the eye processes images. Dr. Hart discusses working with Wavefront: “The technology is continually advancing. The newest three-dimensional tracker adapts to the patient, instead of the patient adapting to the machine. The machine adapts if the patient moves; movement does not affect its precision.”

After the Wavefront-guided technology maps the problem, it transfers the information directly to the laser, and “steers” the laser as it reshapes the cornea. Dr. Hart explains the laser’s interaction with the eye: “The beam moves rapidly across the cornea like a paint brush shaping the way it needs to be in a very precise and specific way.”

Custom LASIK has higher rates of success than conventional LASIK. In a recent FDA study, 95 percent of the participants who underwent custom LASIK attained 20/20 vision or better, while only 75 percent of the participants who received conventional LASIK achieved that kind of vision. Custom LASIK provides the following advantages:

•    A greater chance of achieving 20/20 vision
•    A greater chance of achieving better than 20/20 vision.
•    A reduced chance of losing best-corrected vision.
•    A reduced chance of losing visual quality or contrast sensitivity.
•    Reduced chance of night vision disturbances or glare.

Custom LASIK also makes corrective eye surgery possible for people with some severe refractive vision problems, who may not have been able to be helped by conventional surgery. Custom LASIK can also help patients who have lost their best-corrected vision from a past refractive surgery.

While custom LASIK corrects vision, further customization is often performed after the original surgery. After LASIK, slight aberrations may still be present in the eye. Some surgeons continue to provide customized treatment through individualized touch-ups, so the patients can experience optimal vision. “We provide this personalized post-operative care as part of the LASIK package,” says Dr. Hart. “What are we working to achieve is your smiling face. We do not let go of the problem until the patient is happy with the situation, till they can say ‘now I can see like I want to see.’”