The Truth about Custom LASIK
There’s More to the Truth Than Meets the Eye
As a surgeon, you're always on the lookout for what's best for your patients and your practice. However, with all of the gimmicks and competing claims out there, it can be hard to get to the truth.
What makes for truly custom LASIK?
The fact of the matter is, the leading LASIK systems all offer a custom, wavefront-based solution for your patients. It's not enough to call yourself "true." For a LASIK system to be truly custom, it needs to give you, the surgeon, the flexibility to do more.
Many LASIK systems (including "true" custom LASIK) only offer one type of procedure, so every patient must be treated the same, whether you want to—and whether it makes sense to—or not. What’s truly custom about that?
WaveLight® LASIK offers a custom solution for surgeons and patients alike–and the flexibility you need to do more. Powered by the advanced WaveLight® Excimer Lasers, only WaveLight® LASIK provides multiple custom treatment options and the widest approved range for wavefront-based treatment. You can tailor treatment as you see fit, so you can choose the unique procedure that’s right for your patients:
> Wavefront-Guided LASIK is designed to provide personalized treatment, with a reduction of higher-order aberrations.1,2
- While effective at reducing higher-order aberrations, this option requires a much more time-consuming treatment process of testing, measuring, and refining to get proper wavefront aberrometry–a process that is only truly required to correct a significant degree of higher order aberrations (occurring in less than 15% of cases).3,4
> Wavefront Optimized® LASIK was developed to consider the unique curvature of the eye, preserving the natural, aspheric shape of the cornea, for less induced spherical aberration.5
- Ideal for up to 90% of potential LASIK patients6, Wavefront Optimized® LASIK offers a fast and efficient procedure, with high patient satisfaction7 and throughput.
- Allows you to treat a greater degree of high myopia—and more than double the range of hyperopia—than competing LASIK systems.
- Provides similar visual results to Wavefront-Guided LASIK, without the gathering of aberrometry data.
- As a result, you only need to take the extra steps of Wavefront-Guided LASIK when it makes sense from a medical perspective to do so.
- Only offered as part of WaveLight® LASIK
Comprehensive information on all of the leading LASIK systems is readily available on the FDA Web site where you can find additional details and see for yourself.
Side-by-Side Comparison See more
Compare the Stats on Leading LASIK Systems and Ask Yourself: What Does "True" Custom Really Mean?
Some companies can try to convince you that only they have "true" custom LASIK. When it comes right down to it, though, it’s up to you to decide what makes for a truly custom procedure.
Below, you'll find a side-by-side comparison of the leading LASIK systems. Take a close look at the stats, and see what each system can offer you, your patients, and your practice.
|Type||Scanning spot||Scanning slit||Variable broad beam||Scanning spot||Scanning spot||Scanning spot|
|Beam Size (mm)||1-2||2x9||0.65-6.5||0.95||0.7||0.95|
|Rep Rate (Hz)||100||100||10-20||400||200||500|
|Avg fluence (mJ/cm2)||120||140||200||200||200||200|
|Eye track rate||100 Hz||200 Hz||60 Hz||400 Hz||50 Hz||1050 Hz|
The truth is finally out about "true" custom LASIK–and what WaveLight® LASIK can do to give you more. But don't just take our word for it... Compare specs and come to your own conclusions.
Beam Profile See more
Generally, most newer-generation LASIK systems do not use top hat beams, which provide uniform beam intensity, instead opting for Gaussian beams, which provide non-uniform intensity based on a Gaussian distribution (ie, the beam is more intense along its central axis). Because of these different energy densities, the Gaussian profile offers improved control of pulse shape, as well as maximum uniformity of each emitted pulse.
The rounded Gaussian beam shape also allows for a finer, more uniform pulse overlap, creating a smoother ablation surface and allowing for more precise custom shaping than top hat beams.9
Gaussian beams provide a smoother ablation area without grooves or ridges in the intersection zones. Top hat beams can result in irregular and rough corneal surfaces, increasing the potential for optical aberrations and scattering.9
Beam Size See more
Custom LASIK requires the ability to precisely correct finer features–particularly when addressing higher-order aberrations. Precise correction, in turn, requires a smaller beam to accurately fine-sculpt the eye. Smaller beam size–also known as spot size–can provide a variety of benefits, improving predictability and the ability to efficiently correct both lower and higher order aberrations.10,11
The 0.95-mm, ultra-thin profile of the WaveLight® Excimer Lasers helps assure consistency and precision in corneal shaping, with a larger optical zone (up to 8.0 mm) and very small transition zones.12
Average Fluence See more
Fluence, also known as radiant exposure, is a measurement of energy over area (in this case, the beam size of the laser). The higher the fluence, the more "cutting power" a laser has. Varying beam size–such as that offered by variable broad beam lasers–causes varying energy levels.
Maintaining fluence is crucial for precise refractive procedures, as the programmed correction assumes consistent energy is applied per pulse.8 Unfortunately, environmental and mechanical factors–dust, humidity, ozone–can actually cause the fluence of many LASIK systems to fluctuate, leading to less predictable results. Luckily, WaveLight® Excimer Lasers feature advanced PerfectPulse Technology®, which monitors and helps ensure the energy stability of every pulse, for greater precision and safety, which assist in providing a lower rate of enhancements:
- PerfectPulse Technology® features a smart, closed-loop energy control program that automatically balances energy levels to help ensure each laser pulse creates the same accurate result.
- This same technology forms the foundation for WaveLight® LASIK's unique Wavefront Optimized® LASIK . By compensating for energy loss and potential undercorrection at the periphery of the cornea, PerfectPulse Technology® adds additional pulses to the peripheral cornea, which helps create a more natural, aspheric shape, with less induced spherical aberration.4
WaveLight® Excimer Lasers feature PerfectPulse Technology®, for more consistent energy control.
WaveLight® Excimer Lasers feature 3-sensor energy control. They also check the energy at the point when the beam leaves the laser system. This is important since the energy at the cornea is what matters.
Pulse Frequency See more
Pulse frequency is the "firing rate" of the laser. Faster repetition rates allow for faster treatments and minimal exposure to external environmental influences, to promote more optimal patient outcomes and potentially faster visual rehabilitation.8
The WaveLight® Allegretto Wave® Eye-Q Laser offers a high-speed pulse frequency of 400 Hz, enabling you to achieve a correction time of 2 seconds per diopter. This rapid, efficient treatment offers many advantages to your practice and your patients, including:
- Low potential for complications13
- Decreased exposure to the effects of temperature and humidity13
- Reduced risk of decentration13
- Excellent clinical results13
- Designed to optimize patient flow and throughput with less stromal hydration and flap drying13
High pulse frequency can be associated with elevated corneal temperature when cumulative ablation energy is confined to a small area.10
- Fortunately, WaveLight® Allegretto Wave® Eye-Q Lasers help prevent thermal effects with optimized shot distribution, only allowing every fifth pulse to overlap with a previous one, so that the affected area has sufficient time to cool in between pulse application.
Eye Tracker Sampling Rate See more
Beam size, pulse frequency, energy control–all of these aspects are important when choosing a laser. But a great laser isn't worth anything unless it's supported by an eye tracker that ensures that each pulse is placed exactly where it was intended.3
During treatment, random saccadic eye movements can occur up to 5 times a second, traversing a distance of 0.1-2 mm at a rate of 22-170 mm/sec.3 To compensate for this near-constant pupil shift, eye tracking technology needs to offer rapid latency response time, with extremely accurate eye alignment.
WaveLight® Excimer Lasers use an advanced, high-speed tracking system that follows even the fastest eye movement. Natural eye movements range from 20-60 Hz; the WaveLight® Allegretto Wave® Eye-Q Laser can track pupil shifts at very high rates.
Featuring a synchronous, video-based, closed-loop tracking system, WaveLight® Allegretto Wave® Eye-Q Lasers are designed to help reduce treatment errors caused by eye movement:
- Active video tracking continually verifies eye position and automatically corrects shot placement based on natural eye movement. With rapid image sampling rates and closed-loop feedback of eye position, the tracker maintains a space-stabilized image with minimal latency, which helps to ensure that every pulse goes to the desired location.3
- To maintain high-speed correction, PerfectPulse Technology® multitasks the tracking process. Even as the eye tracker adjusts the mirrors for a pulse, it is already beginning to determine the eye position for the next pulse.