Lasik Eye Lasers: Choose The Best For You

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Lasik eye lasers used in eye surgery are all able to shape the cornea. But when planning your laser eye surgery you should know more about the equipment your eye surgeon uses.

Lasers are used in standard Lasik, Custom (wavefront) Lasik (All-Laser-Lasik), Lasek, PRK, Epi-Lasik, IntraLase, PresbyLasik, and monovision Lasik.

When choosing your eye surgeon you will need to ask about the equipment he uses.

You’ll learn about two distinct uses of Lasik eye lasers, testing and surgery.

One way to learn more about this technology is to ask several eye surgeons about the different equipment, especially the brands and models they use. Be sure to ask why they chose that model over any other.

Also ask why they didn’t choose the other models. Many eye surgeons offer a no-cost consultation. This is a great opportunity to learn from those who use the equipment.

Newer equipment uses wavefront technology. Wavefront measures refraction more accurately than any known method. Most eye surgeons think wavefront should be used for all eye surgery diagnostic testing. But it isn’t always the best choice for treatment.

Wavefront-guided ablation removes more tissue than conventional laser ablation.

Because it can measure higher order aberrations (HOA) wavefront tries to correct those along with the lower order aberrations (LOA) that are being treated.

Several common Lasik eye lasers currently approved by the FDA are compared below.

This information is intended to give you an idea of how they differ. Your eye surgeon can give you more information about how that might affect your personal treatment plan.

WaveLight Allegretto Wave Excimer™ Laser

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The WaveLight Allegretto is a wavefront-optimized laser. The Allegretto uses data to create a “static” ablation map.

Strengths include a larger ablation zone than the VISX S4 and better ablation outcome than conventional laser treatment.

Larger ablation zone: It can ablate an area from 6 mm to 8 mm allowing treatment of larger pupils. This means that it can treat many patients with larger pupils than some other lasers.

Broad range of error correction: It can treat up to -12.0 Diopters of nearsightedness with or without astigmatism of up to 6.0 Diopters.

Better ablation outcome: Wavefront-optimized correction has better outcomes than conventional ablation.

Wavefront diagnostics give more details about both HOA and LOA.

Limitations are that it cannot under correct and it falls short of wavefront-guided outcomes.

Under correction: Since wavefront optimized ablation can’t under correct the ablation, the surgeon can’t use the technique of leaving room for an enhancement after vision stabilizes. This can be a problem for people who have less corneal tissue.

Outcomes using wavefront-guided Lasik eye lasers are generally better than wavefront-optimized or conventional ablation outcomes.

Visx S4 IR CustomVue

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The Lasik eye laser in this model is a wavefront-guided. The S4 IR is also used to diagnose by taking precise measurements of each eye and creating an equally precise ablation map. During ablation, this map is used to shape the cornea to its optimal curve.

Strengths of the S4 IR are in its diagnostic and tracking capabilities.

Diagnostics: As with other wavefront lasers, it can measure precise detail about each eye’s current shape and characteristics. These measurements can be used for both standard laser ablation and for wavefront-guided ablation.

Tracking: The S4 IR model is the first approved by FDA to align its CustomVue treatment using a non-contact, automatic tracking technology and iris registration to ensure precise ablation despite any eye movement.

The S4 IR is designed to conserve tissue, optimize treatment time, and centers the ablation on the center of the eye.

Limitations of the S4 limit its use on certain patients. Some patient’s eye characteristics are beyond the treatable range of the S4.

These include large pupils and astigmatism.

Large Pupils: The S4 has an ablation area of only 6.5 mm. Some people’s pupils dilate larger, for example, up to 7.5 mm.

Astigmatism: The ablation zone for astigmatism is less than 6.5 mm.

Technolas Perfect Vision Zyoptix® Laser by Bausch and Lomb

The Zyoptix is a femtosecond excimer laser that uses wavefront diagnostics. According to their specifications and brochure features include:

Diagnostics: Uses wavefront analysis to create an aberration correction map.

Iris recognition: reduces retreatment by monitoring eye movement

Tissue saving mode: Preserves corneal tissue allowing wider range of patients to be treated with this laser

Pupil shift: compensates for pupil shift

Advanced Control Eyetracking™ enables laser adjustment during ablation

Self centering

Uses two spot lasers: a 1mm HOA and a 2 mm for LOA aberration simultaneously

Greater accuracy

Fewer over corections

Faster stabilization of vision to best corrected

Faster treatment times

Doesn’t flatten the cornea to cut the flap

Reduces induced spherical aberrations

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