Laser-Assisted In Situ Keratomileusis, commonly known as LASIK, is a widely performed refractive surgery designed to correct vision errors by reshaping the cornea. Wavefront LASIK is an evolution of this procedure, offering a highly personalized treatment based on the eye’s unique optical characteristics. This advanced method uses sophisticated measuring technology to create a three-dimensional map of the visual system. This allows for a level of precision not possible with earlier techniques, transforming how light is focused onto the retina and improving visual quality.
Mapping the Eye’s Unique Irregularities
The fundamental difference in Wavefront LASIK lies in the initial diagnostic phase, which uses a device called an aberrometer to gather data about the eye’s optical pathway. This instrument projects a wave of light into the eye, which travels to the retina and is then reflected back out through the pupil. As the light wave returns, any imperfections or distortions it encounters are measured by a sensor.
The result is a detailed, three-dimensional blueprint of the eye’s imperfections, often compared to an optical “fingerprint.” This map captures two categories of visual errors. The first includes lower-order aberrations, which account for about 90% of refractive errors and are corrected by a standard glasses prescription, such as nearsightedness (myopia), farsightedness (hyperopia), and astigmatism.
The aberrometer also measures higher-order aberrations (HOAs), which traditional LASIK cannot detect or treat. These HOAs are complex distortions that significantly impact the quality of vision, even if the eye achieves 20/20 clarity. Specific HOAs include coma, which causes comet-like blurring, spherical aberration, which produces halos around light sources, and trefoil, which results in a triangular distortion. By capturing these irregularities, the wavefront technology addresses issues like glare, halos, starbursts, and poor night vision.
Customizing the Treatment Profile
The information collected by the aberrometer is the foundation for the treatment profile, which guides the excimer laser during the reshaping process. This digital wavefront map is electronically transferred directly to the laser system, ensuring the correctional treatment precisely matches the eye’s unique measurements. This planning phase designs a custom ablation pattern for the corneal surface, moving beyond simply correcting the basic prescription.
Traditional LASIK relies on a standardized treatment profile for every patient with the same prescription, focusing solely on lower-order errors. In contrast, the Wavefront profile dictates a specific, microscopic adjustment at thousands of points across the cornea. This compensates for both the lower-order refractive errors and the HOAs. This level of customization ensures the final corneal surface is smooth and uniform, improving both the quantity and quality of vision.
The treatment profile is designed to minimize the potential for post-operative side effects that arise from surface irregularities, especially those that manifest in low-light conditions when the pupil dilates. By creating a smoother optical surface across the entire treatment zone, the personalized profile reduces the likelihood of inducing new aberrations. This planning phase translates the eye’s unique optical characteristics into precise instructions for the laser during the surgical correction.
Steps During the Laser Correction
The Wavefront LASIK procedure is a brief, two-stage process that begins after the eye is prepared with topical anesthetic drops. A device is placed on the eye to keep the eyelids open, and a suction ring is applied to stabilize the eye during the initial stage. The first stage involves creating a thin, hinged flap on the cornea’s surface. This is accomplished using either a mechanical microkeratome blade or, more commonly, a femtosecond laser for a blade-free approach.
Once the flap is created, the surgeon lifts and folds it back to expose the underlying corneal tissue, called the stroma. This exposed tissue is the area reshaped to correct the refractive errors. The excimer laser is then activated, delivering ultraviolet light pulses according to the custom treatment profile derived from the aberrometer map.
The laser system incorporates an eye-tracking mechanism that locks onto the eye, ensuring the laser pulses are applied with microscopic accuracy, even if the eye makes small movements. The laser ablates tissue in microscopic increments to achieve the precise curvature required by the customized plan. After the laser correction is complete, the corneal flap is repositioned back onto the eye, where it adheres naturally without the need for sutures.
Immediate Recovery and Follow-Up Schedule
Immediately following the procedure, the effects of the numbing drops subside, and patients commonly experience a gritty, burning, or foreign-body sensation. Increased tearing and sensitivity to light are also expected temporary side effects. Patients are required to have someone drive them home and are advised to rest with their eyes closed for several hours.
To protect the eyes and prevent rubbing, a protective shield is worn, often just for the first night. Vision will be hazy or blurry right after the surgery, but significant improvement is noticeable by the next morning. A mandatory follow-up appointment is scheduled for the first 24 to 48 hours post-surgery. During this appointment, the surgeon checks the flap’s position and tests the initial visual acuity.
The immediate care plan includes using prescription eye drops, consisting of an antibiotic to prevent infection and a steroid to control inflammation. Further follow-up appointments are scheduled within the first week and month to monitor the healing of the corneal tissue and the stabilization of vision. During this time, it is important to avoid rubbing the eyes and to follow all instructions regarding water exposure and physical activity.