wavefrontguided

Wavefront-guided refers to a type of refractive surgery approach that uses subject-specific measurements of the eye’s wavefront to guide the laser ablation pattern. The goal is to correct both lower-order refractive errors such as myopia, hyperopia, and astigmatism, and higher-order aberrations that can degrade image quality.

Measurement is obtained with a wavefront sensor, often a Shack-Hartmann device. The captured wavefront is decomposed into Zernike polynomials to quantify aberrations across the optical zone. The ablation pattern is computed to reduce the measured wavefront error, delivering a customized correction. The treatment is delivered by a laser and aligned to the pupil, with attention to cyclotorsion and centration. Planning may use a pupil size different from the pupil size evaluated postoperatively.

Applications include LASIK and PRK for refractive error correction; in some cases, wavefront-guided approaches are used in refractive cataract surgery to improve visual quality, including compatibility with toric or multifocal intraocular lenses.

Advantages of wavefront-guided treatment can include improved correction of higher-order aberrations and potential gains in night vision and contrast sensitivity. Limitations include reliance on accurate wavefront measurements, potential performance variation with irregular corneas, sensitivity to pupillary size and measurement or alignment errors, and requirements for compatible laser platforms and instrumentation.

Compared with wavefront-optimized techniques, which aim to minimize induced spherical aberration without patient-specific data, and with topography-guided approaches that emphasize corneal surface data, wavefront-guided methods seek to tailor correction to the eye’s unique optical imperfections for potentially enhanced visual quality.