title: A comparison of wavefront-optimized and wavefront-guided ablations.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland 21093, USA.
authors.forename: Elliott H
authors.initials: EH
authors.lastname: Myrowitz
authors.forename: Roy S
authors.initials: RS
authors.lastname: Chuck
mesh_terms: D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods* / Q000639:trends; D054018:Lasers, Excimer; D055095:Optics and Photonics; D017060:Patient Satisfaction; D016896:Treatment Outcome; D014792:Visual Acuity