[Ablation profiles in refractive surgery. Part 1: in search of excellence].
OBJECTIVE
To provide an overview of the clinical results of various ablation profiles and discuss their technical characteristics and limitations.


METHODS
Literature review.


RESULTS
With the emergence of wavefront technology, new photoablation profiles have been developed, allowing for customization of refractive treatments and reduction of nocturnal visual symptoms, which adversely affect the reputation of refractive surgery. Over the past decade, several comparative studies have been published in the literature aiming to demonstrate either the superiority of wavefront-guided correction over conventional, or one laser platform over another. However, has an ideal treatment algorithm really emerged from these studies? Does one ablation profile clearly demonstrate superiority over another, in terms of visual performance?


CONCLUSIONS
Despite technological advances as well as improved visual results for custom versus conventional photoablation, the promise of excellence in visual performance has not been achieved with these various technologies. The concept of an individualized eye model has emerged recently, based on an optical ray tracing algorithm, and could theoretically provide an ideal ablation profile, thus fulfilling the promise of "supernormal vision".
Unité de segment antérieur et de chirurgie réfractive, service d'ophtalmologie, hôpital Pellegrin, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. david.smadja@chu-bordeaux.fr
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Reggiani-Mello
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Touboul
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Colin
D055011:Ablation Techniques / Q000009:adverse effects / Q000379:methods; D019781:Corneal Topography / Q000379:methods / Q000706:statistics & numerical data; D005128:Eye Diseases / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D009885:Ophthalmology / Q000379:methods / Q000592:standards* / Q000639:trends; D057285:Precision Medicine; D011785:Quality Assurance, Health Care; D054140:Refractive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome