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Wavefront still up the road, not exactly around the corner
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SAN DIEGO – In the year 2000, wavefront was the buzz-word intriguing surgeons and promising that soon laser vision correction would be lowering the bar from 20/20 to 20/10 and maybe further. However, one year later, the presentations at the American Society of Cataract and Refractive Surgery seem to be promoting a more cautious concern for the use of wavefront.
Jack Holladay, MD, presented less than one-month-old data of a one recent enhancement he performed using the custom ablation. While he achieved very good results, Dr. Holladay said the results made him much less optimistic about custom ablation re-treatments under a Lasik flap, but rather, he thinks re-treatments may be better served with the use of PRK.
Echoing Dr. Holladay’s concern regarding the abilities of custom ablation in certain circumstances, Manus Kraff, MD, warned that wavefront still has a long way to go. He explained that surgeons still need to learn how best to read the maps wavefront create and they also need to learn exactly what higher order aberrations mean to total visual acuity.
Dr. Kraff explained that his own studies showed that while regular, low-order aberration surgery increases higher order aberrations, the visual outcomes improve anyway.
While caution seemed to be the tone of the majority of the presentations, there was news of the progress of wavefront. D. Keith Williams, MD presented information regarding his five patient study using the Visx S3 ActiveTrak system and the Visx PreVue lens system.
Dr. Williams retreated five patients who had undergone prior Lasik surgery, but with very poor results, including low visual acuity and ghosting. By using Visx’s WavePrint system, he was able to fashion PreVue lenses corrected the failure of the prior surgery and adjusted for the patients’ higher-order aberations. If after testing the PreVue lenses the patients noticed a significant improvement, then they were retreated using the same parameters that were used to make the PreVue lenses.
The results were excellent. All five patients made remarkable improvements, though only three of the five improved beyond 20/30 UCVA.