• First, Anesthetic drops are applied to the eye.
• Shortly thereafter, the surgeon will create a protective flap. This flap is created with IntraLase or (Bladeless) laser technology, and lifted by the surgeon to reveal the inner corneal tissue.
• Computer-controlled pulses of cool laser light are then applied to the inner layers of your cornea. As the laser pulses, you will hear a ticking sound. The inner cornea layer is reshaped with the laser to correct your vision.
• The surgeon then replaces the flap.

• Studies have shown the incidence of dry eye symptoms may be reduced with Bladeless LASIK.
• With Bladeless LASIK surgeons can treat a wider variety of patients, including patients with thin corneas.
• Bladeless LASIK has been used in more than one million LASIK procedures worldwide.

The term “Custom Lasik”  is misleading, because it implies that there is also some type of Lasik that is  non-custom.  Actually, every Lasik treatment for every eye  is specifically ‘customized’ to treat the vision in that eye,  just as every pair of glasses or contact lenses  is specifically ‘customized’ for the person who will be using them.

The term “Custom Lasik”, which is essentially a marketing gimmick, refers to an optical measurement known as the  wave front.  Notice how many vision correcting systems and lasers have the word ‘wave’ in their name.   The wave front is a concept described by the Belgian physicist  Zernike in 1934.

When a patient is measured for eye glasses or contact lenses, we put a series of lenses in front of each eye and ask, “which is better, this lens or that lens”.  This kind of testing is used to  measure lower order aberrations, and it is excellent for glasses and contact lenses.  Wave front technology can be used to measure higher order aberrations, which can be  important part of Lasik treatments.  All modern Lasik treatments correct lower order aberrations, and combine that with one of two different types of wave front treatments: Wave Front Guided (WFG) and Wave Front Optimized (WFO).  Most Lasik lasers in the United States can perform WFG treatments, but not WFO treatments.  The WaveLight Allegretto laser that we use at Barnet Dulaney Perkins Eye Center can do both WFG treatments and WFO treatments, although we definitely prefer to use WFO treatments for our patients.

These comments are not intended as a negative criticism of WFG Lasik treatments.  In eye surgery medical journals, some articles conclude  that WFO treatments are better than WFG treatments.  Some articles state the opposite.  Other articles  conclude that WFO and WFG produce equally good results.

Lasik treatments for patients who are nearsighted change the normal shape of the cornea (front ‘window’) of the eye in a way that actually induces a type of higher order aberration called spherical aberration.  Spherical aberration is  the leading cause of night time glare and halos around lights after ‘successful’  Lasik.  WFO treatments are specifically customized for every eye  to maintain the normal shape of the cornea.  WFG treatments do not  address this problem.  That is why the WaveLight Allegretto laser is the only Lasik laser in the United States approved by the FDA to reduce the risk of night time glare.