Wavefront or Custom LASIK was approved by the FDA over 13 years ago in October 2002. It improved the accuracy of LASIK surgery and decreased the risk of glare and haloes. In FDA trials, the majority of patients found their vision to be better at night after custom LASIK than with contacts or glasses. One FDA study found 70 percent of custom LASIK patients saw better than 20/20. On July 20th, 2015, the FDA approved the latest advance in Custom LASIK called iDesign Advanced Wavescan. To further improve upon these results, North Shore Eye became one of only 30 centers in the United States to adopt iDesign for the treatment of myopia and astigmatism. In a clinical study on 334 eyes treated with the iDesign System, 99 percent of patients experienced little or no difficulty with the clarity of their vision and 97 percent of patients had little or no difficulty with their daily activities after surgery. In addition, patients saw significant improvements in their vision while driving at night and a reduction in glare.
Custom LASIK was adapted from a technology used in astronomy. The theory began in the 1930’s by a german physicist named Zernicke. For those interested in astronomy, NASA used this technology to correct the Hubble space telescope and is using the same technology to measure and shape the mirrors for the James Webb space telescope to improve its acuity and ensure it will transmit high resolution images of deep space (the telescope is scheduled to be launched in 2018) https://www.youtube.com/watch?v=t2U12h6udwE&feature=youtu.be.
Essentially a wave of light from a laser is sent through the eye and reflected back. Irregularities in the eye alter the wavefront that returns and is detected through an array of microsensors. A wavefront map is produced that shows specific aberrations that is unique to the shape of each individual eye. This wavefront map is then used to guide an excimer laser that reshapes the cornea during LASIK surgery to correct these aberrations.
iDesign improves upon Custom LASIK by having 5x the resolution (1200 microreading). More patients will qualify for iDesign because the pupil only needs to be larger than 4 mm as opposed to 5 mm with the previous Wavescan device. It can also capture up to 8.5 mm of wavefront data as opposed to 7.0 mm. The device makes it easier to capture the most accurate prescription possible by suggesting a prescription based on the Wavefront map that the doctor will refine. As an additional measure of security, iDesign will check to make sure the wavefront prescription and the doctor’s prescription do not deviate significantly. In addition, iDesign also measures the shape (topography) and curvature (keratometry) of the cornea and the pupil diameter under different lighting conditions to help with LASIK planning. Early results have shown more accurate cylinder correction and better quality of vision with iDesign. We can also treat higher levels of astigmatism (5.0 diopters vs. 4.0 diopters with earlier Wavescan device) and treat younger patients starting at the age of 18. It is not uncommon for our patients to have better than 20/15 vision (better than 20/20) after iDesign Lasik.
Custom LASIK is not for everyone though as it removes more corneal tissue than conventional LASIK. Therefore, patients with thin corneas, undilated pupils < 4.0 mm, high aberrations, severe dry eyes, and conditions that affect the lens or vitreous (the gel in the eye) may not be good candidates. These patients may still qualify for conventional LASIK though. So if you have been considering LASIK surgery, this is a great time to make an appointment for a free evaluation at one of our 8 locations throughout Long Island or to attend one of our LASIK seminars in Smithtown.