A comparison of wavefront-optimized and wavefront-guided ablations

Elliott H. Myrowitz, Roy S. Chuck

Research output: Contribution to journalReview articlepeer-review

43 Scopus citations


PURPOSE OF REVIEW: Optimized aspherical as well as custom wavefront-guided treatments attempt to reduce the induction of visually disturbing aberrations than can occur with conventional spherocylindrical corneal ablation. This review highlights a comparison of the advances and limitations of the two treatments. RECENT FINDINGS: Optimized aspherical as well as wavefront-guided corneal excimer laser treatments have continued to improve in outcomes compared with conventional treatments. Wavefront-guided as well as wavefront-optimized treatments yield high predictability, efficacy, and safety. Equally good vision has been obtained as measured by snellen acuity, patient questionnaires, and total residual higher-order aberrations. Wavefront-guided treatments did have better results in spherical aberration, coma as well as contrast sensitivity outcomes. Surgeons who have easy access to both technologies suggest using wavefront-optimized treatments in 67-88% of patients and reserve wavefront-guided treatments for those who have above average higher-order aberrations. However, even with individually adjusted aspheric, 'Q' values, optimized ablations still increased higher-order aberrations and wavefront-guided treatments also did not achieve the elimination of residual higher-order aberrations. SUMMARY: Optimized aspheric corneal ablations that attempt to avoid reducing the prolate eccentricity of the average cornea as well as wavefront-guided treatments that attempt to reduce the individual whole-eye aberrations have continued to improve visual outcomes compared with conventional treatments.

Original languageEnglish (US)
Pages (from-to)247-250
Number of pages4
JournalCurrent opinion in ophthalmology
Issue number4
StatePublished - Jul 2009
Externally publishedYes


  • Corneal eccentricity
  • Laser-assisted in-situ keratomileusis
  • PRK
  • Spherical aberration
  • Wavefront-guided
  • Wavefront-optimized

ASJC Scopus subject areas

  • Ophthalmology


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