title: Wavefront ablation profiles in refractive surgery: description, results, and limitations.
abstract: OBJECTIVE
  To provide an overview of the clinical results of different ablation profiles based on wavefront technology and discuss their characteristics and limitations.
  
  
  METHODS
  Literature review of studies reporting results of ablation profiles based on wavefront technology in virgin healthy eyes.
  
  
  RESULTS
  Over the past 10 years, a large number of studies comparing different treatment algorithms and newer excimer laser platforms have been published. Thirty-six clinical studies including 3637 eyes analyzing the clinical results obtained after wavefront-guided, wavefront-optimized, and Q-factor profiles have been reviewed. Although wavefront-driven profiles allowed reduction of the amount of induced optical aberrations with conventional ablations, thereby improving the quality of vision, it appears that no algorithm of treatment or excimer laser platform has demonstrated a clear superiority over another. Wound healing and unexpected biomechanical response to surgery affect the accuracy of customized treatments and produce variable results. In addition, it is difficult to rigorously analyze and compare findings among different studies because of the diverse variety in which the data are reported.
  
  
  CONCLUSIONS
  Despite several technological improvements over the years, wavefront ablation profiles have not consistently demonstrated superiority in terms of visual acuity and lower order aberrations compared to the standard procedure, although the induction of higher order aberrations has been reduced. The concept of an individualized eye model has emerged recently, based on the optical ray tracing algorithm, and could theoretically provide a higher level of customization, thus fulfilling the promise of "super vision."
authors.affiliation: Refractive Surgery Department, Cole Eye Institute, Cleveland Clinic Foundation, Ohio, USA. davidsmadj@hotmail.fr
authors.forename: David
authors.initials: D
authors.lastname: Smadja
authors.forename: Glauco
authors.initials: G
authors.lastname: Reggiani-Mello
authors.forename: Marcony R
authors.initials: MR
authors.lastname: Santhiago
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Krueger
mesh_terms: D001251:Astigmatism / Q000601:surgery*; D003319:Corneal Stroma / Q000601:surgery; D048988:Corneal Surgery, Laser / Q000379:methods*; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery*; D016896:Treatment Outcome