Question: What are the differences between wavefront-guided, wavefront optimized and conventional LASIK? (Risks/benefits?)
Answer: During the LASIK procedure, the laser can be programmed in a variety of different ways. Initially we utilized only the refraction to guide the programming of the laser. The refraction is what the ophthalmologist performs in the office using lens' either in a trial frame or device held in front of your eyes called the phoropter, where the doctor may present different lenses and ask you which is better: number one or number two. That was the basis of programming the laser for conventional LASIK.
Two other options which are available are wavefront-optimized and wavefront-guided laser treatments. Wavefront optimized tries to minimize the induction of aberrations in the eye, particularly one aberration which is called spherical aberration.
Wavefront-guided treatments utilize a device to measure your eyes' wave of light -- that is, it measures the exact prescription of your eye across many points throughout your pupil. In a sense, this gives the ophthalmologist the same information as a refraction, but also lets the ophthalmologist know which aberrations may be present in your eye. These aberrations are not normally corrected with glasses, and so it allows the ophthalmologist to program the laser in a special way as to try to offset the existing aberrations in your eye, in addition to trying to minimize the induction of any new aberrations. The goal is therefore to achieve the best possible vision, and the highest quality vision even in low lighting conditions. Wavefront-guided treatments may be particularly useful in patients who have high degrees of pre-existing higher order aberrations going into surgery. The decision as to whether or not to undergo wavefront-guided, wavefront-optimized or conventional laser vision correction can only be made by a consultation with your ophthalmologist, who will be assessing all of these parameters that will influence that decision.