Wavelight optimized or guided?

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Wavelight optimized or guided?

Postby xrayvision » Sun Dec 30, 2007 10:22 pm

Hi Guys

Firstly, I wish to say this site is brilliant! I'm in the UK and forums are limited in info and also funded by providers which make them biased.

I am thinking of going ahead with the procedure following a couple of consultations, both of whom say I am suitable for lasik, and both use the Allegretto wavelight 400 hz. One is offering the optimized treatment and the other the guided. Now I have asked for information about RMS figures for high order aberrations and am still awaiting their feedback.

In your expert opinions what would be the best treatment to go for i.e. which method would yield a more satisfactory outcome? Price, naturally, is not an issue. I'm a 29 yr old male:

My Prescription
Right Eye -6.75 / cyl -0.25 / Axis 180
Left Eye -7.00 / cyl -0.75 / Axis 166

I hope these numbers are sufficient for someone to help make my decision.

Thanks in advance for any contributions!
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Postby LasikExpert » Mon Dec 31, 2007 2:33 am

The numbers you provide are your eyeglass or contact lens prescription. They show that you have moderately high myopia (nearsighted, shortsighted) vision. Your error is within the treatable range for both the Allegretto custom wavefront-guided and the wavefront-optimized treatment methodology. What is not shown is the higher order aberration (HOA) information that may indicate that wavefront-guided is a requirement.

As a (very) general rule, custom wavefront-guided abaltion will yield a better outcome than wavefront-optimized, and wavefront optimized will yield a better outcome than conventional ablation. This is a general rule, but there may be issues unique to you that indicate one is better than the others. That is why a comprehensive evaluation by a competent surgeon is so important.

For details, read about wavefront custom Lasik.

No matter what technology selected, it is reasonable to expect Lasik regression of effect. Your surgeon may want to deliberately overcorrect you to allow regression to bring you back to the target, or plan enhancement surgery after regression settles.
Glenn Hagele
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Postby Chow Yun Fat » Wed Jan 02, 2008 8:09 am

There is a webinar on Wavelight's web site about their optimized and guided treatment.

http://www.wavelight.com/InfoCenter/
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Postby xrayvision » Wed Jan 09, 2008 9:40 pm

Thanks Glenn

I now have my HOA numbers:

Right eye RMS:0.15
Left eye RMS: 0.20

From what I have read on your site for best results, RMS below <3 the wavefront optimized has proven to yield slightly better results? Is my understanding of this correct? Are any other considerations necessary other than HOA's in determining whether or not guided or optimized should be used?

Thanks for the link Chow Yun Fat, it appears you need passwords and viewing is meant for professionals who have the right credentials to register :(

Also how come corneal thickness can vary so much between clinics?

Thanks again for your time and responses!
xrayvision
 
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Postby LasikExpert » Wed Jan 09, 2008 10:45 pm

If this is your total HOA, your numbers are very low. You probably have excellent corrected vision. That is great, but there may be a problem with becoming "normal".

As a general rule, all laser vision correction surgery will increase HOA, not always and not all types of HOA, but as a general rule HOA will increase. The increase in HOA is less with wavefront optimized ablation when compared to conventional ablation, and is even less with custom wavefront ablation when compared to wavefront optimized. See our article about wavefront Lasik.

Several studies indicate that about .30 to .35 RMS is normal total HOA. You are lower than normal, but it would be reasonable to expect that after surgery your HOA could be elevated to the "normal" range. The thing is, you are not accustomed to "normal" vision. You are accustomed to vision with superior optics.

As another example, Snellen 20/20 is "normal" vision. That means that you see an object 20 feet away with the same clarity a person with "normal" vision would see that object from 20 feet away. If you are 20/15, then you see an object 20 feet away with the clarity a "normal" person would see that object from 15 feet away. If your vision before Lasik is 20/15, and if your vision after surgery was 20/20, you would actually be going downhill to become "normal".

The question is, would you be 20/Happy with "normal" vision if it is actually of a lower quality than your current vision with corrective lenses? That is something you need to discuss with your doctor.

xrayvision wrote:Also how come corneal thickness can vary so much between clinics?


The cornea has different thicknesses at different locations and different technologies can report different thicknesses. It is important for the surgeon to use consistent measurement systems throughout.
Glenn Hagele
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I am not a doctor.
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