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Custom LASIK

Custom LASIK differs from conventional LASIK in that the measurements of your eyes that are used for laser vision correction are made more accurately and precisely. With conventional laser vision correction procedures, the standard measurements for glasses are used by the laser to correct your nearsightedness and astigmatism. With custom LASIK, a wavefront machine measures all the imperfections unique to your eyes, with 25 times more precision than the standard measurements for glasses. So, custom LASIK provides you with a more precise and individualized approach to laser vision correction.

What does that mean to me? Will I notice a difference?
In the FDA study using the custom treatment (CustomVue) on the Visx Star S4 laser, 70% of patients could see better than 20/15 without glasses or contacts. In that same study, 98% of patients could see 20/20 or better without glasses or contacts. On the whole, patients said their night vision was better after treatment as compared to night vision before the procedure with glasses and contacts. With custom lasik, you have a greater chance of 20/20 or better uncorrected vision, when compared to conventional lasik.

Can anyone get customized lasik?
Custom lasik using CustomVue with the Visx Star S4 laser is currently approved for nearsightedness, farsightedness, and astigmatism. Your doctor can tell you if you meet the specific criteria. In addition, there are some patients who should have conventional lasik. These patients may not do as well with custom lasik. Only your eye care professional can tell you if custom lasik is best for you. Remember, conventional lasik is not “second best”; it does provide excellent results. As an analogy to highlight the difference between conventional and custom lasik, conventional lasik is like getting fit with a very expensive, off-the-rack suit, whereas custom lasik is like getting a suit custom fit by a Hong Kong tailor.  You can "look" great with either.

Custom LASIK procedure and “wavefront”

First, a wavefront machine is used to measure your eyes. The wavefront machine used with the Visx Star S4 laser, is called the WaveScan. The WaveScan machine measures your eyes using light; it is non-invasive and does not hurt. A harmless beam of light is directed into your eye. The light passes through your cornea (the clear window or covering of your eye), through the pupil and lens, and then is reflected by the retina (the inner lining or “film” of the eye). The reflected light bounces back out the way it came, through the lens, pupil, and finally, the cornea. The WaveScan machine measures how the light comes back out.

When doctors talk about “wavefront”, they are referring to the shape of the light as it moves through space. When the light beam from the WaveScan enters an eye, it has a perfectly flat wavefront. Picture the waves that wash ashore at a beach. The edge of the water is generally a fairly straight line. In theory, a perfect human eye would reflect back a light beam with its wavefront still flat. But the human eye is not perfect, there are imperfections in the optical system of the eye. These imperfections could come from a cornea that has scars or is not shaped perfectly, or from a lens that is not perfectly shaped. In such an imperfect system, light may go into the eye with a perfect wavefront, but it comes out with an irregular wavefront. Picture how the waves of water washing ashore on a beach appear, if there are rocks sticking out from the sand. Rather than looking like a straight line, the edge of the advancing water is irregular, perhaps lagging where it was obstructed by the rocks.

The WaveScan records the wavefront of your eye and generates a picture called a WavePrint map. Your WavePrint map is like a “fingerprint” of your eye; no two eyes have the same WavePrint map.

The wavefront data is converted into a complex mathematical formula. This information is transferred to the Visx Star S4 laser. Your eye surgeon first creates the lasik flap. The laser then lays down the treatment that corrects the imperfections of your eye, with the goal of making the wavefront flat or ideal.


Custom LASIK and Iris Registration

Iris Registration (IR) is an exclusive VISX laser technology that allows precise matching of treatment calculations to the actual eye undergoing laser treatment. When a patient elects for CustomVue, VISX’s customized laser treatment, the WaveScan instrument captures the measurements of a patient’s eye. Since the laser treatment is done on a separate machine, the Star S4, it is very important to make sure the planned treatment measurement precisely matches the actual eye under the laser. The eye can rotate when a patient goes from the sitting position (the situation when WaveScan is used) to the lying down position (the situation when the Star S4 laser is used). Both the WaveScan and Star S4 laser, has software that can identify iris landmarks which are unique to each patient’s eyes. By comparing the picture of the iris, capture by the WaveScan, to its own, live picture of the eye under the laser, the Star S4 laser, can adjust the treatment orientation to the actual orientation of the eye under the laser. This helps to fully realize the potential of customized treatments, resulting in superior vision results.


The PreVue Lens

The PreVue lens is an option with the CustomVue lasik procedure. Once your WaveScan measurements are taken, a plastic lens is placed under the Visx Star S4 laser. Your unique correction is created on the lens. The lens is fitted into a frame for viewing, so you can “preview” an approximation of the potential result after custom lasik using CustomVue. Not everyone needs to have this preview. Your doctor can best advise you.


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