Custom LASIK

Custom LASIK surgery has taken the advances of conventional LASIK many steps further by allowing surgeons to correct visual aberrations that previously could not be addressed with traditional LASIK surgery. Custom LASIK eye surgery offers patients a better chance of achieving visual acuity superior to that provided by contacts or glasses.

LASIK vs. Custom LASIK

In the past, LASIK eye surgery was based simply on your prescription: whether you were nearsighted, farsighted, or astigmatic, and your degrees of each. However, excellent vision is also dependent on higher-order aberrations - more complicated and personalized visual imperfections that affect the crispness and clarity of your vision. New custom LASIK technology is able to diagnose and treat these visual imperfections like never before. Custom LASIK eye surgery has the same mechanical components of traditional LASIK, but is fully personalized and guided by a detailed Wavefront map of your eyes.

Custom LASIK surgery uses advanced Wavefront technology to correct visual flaws not addressed by traditional LASIK. This provides patients with vision correction tailored to address their own unique needs, often leading to better vision after the procedure has been completed. On this page, learn more about the custom LASIK procedure and what you can expect during your surgery.

Wavefront LASIK Technology

Wavefront mapping for LASIK eye surgery is able to detect and measure optical imperfections 25 times more precisely than standard methods.

This mapping takes advantage of the properties of light. Specifically, light travels in flat sheets, called wavefronts. To generate a Wavefront map of a person's eye in preparation for laser eye surgery, a safe beam of light is passed through the patient's eye. This beam of light passes through the eye's optical system (the cornea, lens, and retina), and reflects it back, at which point the Wavefront diagnostic machine captures and measures it. If the eye's system was perfect, the ray of light would exit just as it entered the eye - as flat sheets. However, in an eye with lower- and higher-order aberrations, the ray will become distorted. Translating this distorted light into a Wavefront map of the eye's imperfections is the basis of custom LASIK.

• Three-Dimensional Mapping: Over 60 patterns of higher-order aberrations exist alongside the common problems of nearsightedness, farsightedness, and astigmatism. These various imperfections exist to different degrees, and often vary between a person's two eyes. It is no surprise, then, that the more detail and realism a Wavefront^TM map is able to convey, the better. Today's Wavefront^TM laser eye surgery sensors are able to map both lower- and higher-order aberrations on a highly detailed, three-dimensional diagram of the eye.
• Transfer Map to Computer-Controlled Laser: Once a Wavefront^TM LASIK sensor has identified, measured, and mapped the eye's specific irregularities, special software converts these data points into a mathematical algorithm. This algorithm acts as treatment instructions for the excimer laser that carries out the actual LASIK procedure. Today's best Wavefront^TM sensors are seamlessly integrated with excimer laser eye surgery systems. Such integrated technology ensures that your unique visual challenges are diagnosed, measured, and treated, with no information lost en route.

Preparing for Custom LASIK Surgery

An initial consultation with your doctor will determine if you are a good candidate for custom LASIK surgery. During the consultation, your doctor will ask for a complete medical history and give you specific instructions concerning how to prepare for surgery, including important pre-surgery rules for eating and drinking, smoking, and taking medications.

If you wear contact lenses, you will need to stop wearing them for a period of time before your initial consultation and your surgery. Depending on what type you wear, contact lenses can change the shape of your cornea for several weeks following use. Talk to your doctor about the length of time you will need to go without contacts before your appointment. Additional visits may be required before your surgery to ensure your eye is properly prepared and stable.

The day before your custom LASIK surgery, you should not wear any creams, lotions, makeup, or perfumes that may cause an infection in your eyes after the procedure.

The Custom LASIK Procedure

LASIK surgery generally only takes between five and ten minutes for each eye, and both eyes can be done on the same day.

• Creating the Corneal Flap: Before reshaping the cornea with a laser, the surgeon will create a small flap in the surface of the eye using either a laser or a small blade called a microkeratome. The doctor will leave part of the flap connected by a tiny hinge. The flap is then folded back to reveal the surface of the cornea to be reshaped.
• Reshaping the Cornea: Guided by the Wavefront map created prior to the surgery, the excimer laser will remove corneal tissue from the eye through a series of pulses. The reshaped cornea will more accurately refract light onto the retina, creating clearer images.

Based on the map of the eye, custom LASIK also corrects pre-existing higher-order aberrations that create halos, glare, poor night vision, haze, and starburst patterns. After the cornea is correctly reshaped, the flap is replaced over the eye, where it naturally adheres to the surface.

After Custom LASIK Surgery

Following your custom LASIK surgery, your vision should improve almost immediately. However, eye drop medication used to lubricate and protect your eyes may cause some blurring. You should arrange for transportation to and from the surgeon's office, as you will not be able to drive home following the surgery.

Clear plastic shields will be taped over your eyes following the procedure to prevent you from bumping or touching your eyes. Some patients may receive non-prescription safety glasses instead of shields.

Your doctor will probably prescribe eye drops for you to use for about a week following surgery to help reduce inflammation and the risk of infection in your eyes. Within a matter of days, your vision should continue to get better. Over the next year, you will have several post-operative check-ups with your LASIK surgeon who will track your progress and ensure that your vision correction was wholly successful. You should have an appointment several times over the first month, and then less frequently as time goes on and the likelihood of complications decreases.

Custom LASIK Risks

Custom LASIK is associated with complications that are similar in nature to those of conventional LASIK. However, studies on custom LASIK have shown that the risks of these complications are lower than with standard LASIK. It's been shown that complications arise in only 0.03 percent to 5.7 percent of all custom and conventional LASIK procedures combined. Almost all are resolved within six months and without permanent vision loss. An even lower percentage of complications are attributed to custom LASIK cases.

Custom LASIK Statistics

Studies have shown that custom LASIK produces some of the best results in laser eye surgery:

• According to a 2003 study of custom LASIK patients, nine months after their surgery, 72 percent of the 118 patients had 20/20 vision or better. In the same study, 49 percent of patients reported they were able to see as well as or better than they could with glasses before their procedure.
• The study also showed that not only did patients' visual acuity improve, but their quality of vision did as well. Six months after their treatment, approximately 91 percent of the patients reported experiencing a level of visual sharpness and clarity that was at least as good as what they experienced with glasses before their surgery. The same percentage reported that their night driving vision was the same as or better than it was with glasses before their surgery.
• According to the U.S. Food and Drug Administration, several studies that compared custom LASIK eye surgery with conventional LASIK surgery showed that a slightly larger percentage of custom LASIK patients achieved 20/20 vision without glasses or contact lenses.

Custom LASIK Costs

Although custom LASIK costs can be expensive, there are a number of financing options that many eye care specialists are happy to provide. In general, the custom LASIK procedure ranges in price from $1500 to $2500 per eye.

Custom LASIK Systems

There are multiple custom LASIK systems on the market that use Wavefront LASIK technology. Each of these custom LASIK systems incorporates the three-part LASIK procedure, beginning with the mapping of the eye, then the creation of the flap, and finally corneal reshaping. Most LASIK doctors use at least one of the following custom LASIK systems at their practices:

• LADARVision® CustomCornea® system: Able to track eye movements up to 4,000 times per second, this system is FDA approved for the treatment of a range of vision impairments.
• VISX® CustomVue^TM and WavePrint^TM system: Featuring an active track program, this system automatically follows any eye movement and adjusts accordingly.
• Bausch & Lomb's Technolas® Zyoptix^TM system: The most popular laser system in the world for custom LASIK procedures.
• Wavelight Allegretto Wave® system: FDA approved for the treatment of nearsightedness, shortsightedness, and astigmatism.

Contact a LASIK Surgeon

To find out if you are a good candidate for custom LASIK, find a LASIK surgeon in your area.