Wavefront Analysis

Until recently, the prescription that we received for our glasses or contacts, was the best one that you could be given to see. Yet eye doctors have known that these prescriptions only correct some of the optical errors of your eye (the lower-order aberrations called the sphere and cylinder) and did not provide the ideal optical correction. That situation has now changed.

With the development of devices that allows us to perform a wavefront analysis of your eyes, we can now plan a laser treatment that can theoretically provide the ideal optical correction for your eye. Using a device called a Hartmann-Shack aberrometer or wavefront sensing device, we can now detect the other optical defects in your eye's optical system (the higher-order aberrations) which has the potential to increase both the sharpness of your vision and the quality of your vision.

Diagram 1: Chart of Zernike Polynomials

Light travels in smooth sheets called wavefronts. The irregularities in the optics of your eye (mostly in the cornea and lens), distort the shape of this wavefront and create optic imperfections in how we see. The aberrometer projects a small diameter laser beam onto the retina to create a point light source. The wavefront of the reflected light is analyzed by the aberrometer for optical aberrations.

Diagram 2: Wavefront Measurement Device and Schematic

If the eye has no irregularities, the reflected light rays will come out of the eye in a smooth plane. If the eye has irregularities (higher-order aberrations), the light rays emerge with a unique, deformed pattern.

Diagram 3: Wavefront Error and Simulated Visual Function

Diagram 4: WavePrint Acuity Map

Wavefront data is very useful to confirm a patient's refractive error. I am currently using wavefront analysis to screen for patients who have pre-existing large higher-order aberrations. These are the types of patients who may significantly benefit from customized laser treatments. For instance, patients who already experience glare and halos at night may have a large amount of an aberration called spherical aberration which can be reduced by customized laser surgery. In addition, patients who have had laser surgery and are still having visual problems, can now have a wavefront of their eye obtained; and sometimes, additional treatment with the newer technology can reduce their symptoms and improve their visions.

Dr. Witlin has been performing custom wavefront treatments since FDA approval over a few years ago. We can now do wavefront on most myopic prescriptions, even with moderate astigmatism. Also, for Hyperopic patients approval was 6 months ago. The clinical results have been wonderful and patients have been very pleased with their vision. Although this new sophisticated technology costs more, most patients have felt the extra expense to have been well worth it.

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