Technology Facts - Myths & Misconceptions
Misconception #1
Believing manufacturers claims
"As you research laser surgery, you will find that each manufacturer claims that their laser is the best. What is most important to you however, is to be able to sift through manufacturing propaganda, and get honest, unbiased information. To that end, we are happy to provide the FDA (Food and Drug Administration) results of the laser platforms that are currently available. The FDA data is conclusive, and represents the best results each manufacturer could produce in order to gain approval for use in the United States.
We chose to purchase the Allegretto Wavelight. What would you chose?
Misconception #2
Wavefront guided treatments are necessary to achieve a good result
Wavefront treatments are aimed at reducing aberrations, the source of most nighttime glare complaints, or poor quality of vision. Aberrations generally occur in patients who have large pupils, or more rarely, in patients with unusually shaped corneas. Wavefront aberrations are measured, not surprisingly, with dilation of the pupil. So, if you have a very small pupil, you likely won't have problems with aberrations after laser surgery, no matter what laser is used. At Vivid, two different programs can be used, "Wavefront Optimized" or "Wavefront Guided"; based on your measured aberrations, to tailor your treatment according to what has been shown to be the most effective.
In order for you to benefit from a wavefront treatment, the laser system should do 2 things. First and foremost, it should not create nor increase the aberrations of the eye. Secondly, it should decrease the aberrations that exist. Again, we present the FDA results of each laser manufacturer with respect to aberrations following laser treatment.
| ALLEGRETTO WAVE wavefront-guided |
No significant increase of RMSh across all eyes and refractions
17% reduction in trefoil across all eyes
27.27% reduction for eyes with pre-operative RMSh of 0.4µ or more |
| Alcon Ladarvision |
20.6% average increase of RMSh with CustomCornea
56.9% average increase of RMSh with conventional LASIK |
| VISX Star S4 CustomVue |
No data about aberrations or aberration changes reported, only statement:
"Average higher order aberrations did not decrease after treatment"
(See statement below) |
| Bausch and Lomb |
13.4% average increase of RMSh with Zyoptics
45.3% average increase with conventional Planoscan treatment |
As you can see, the Wavelight allegretto was the only laser manufacturer to reduce aberrations.
AMO star's (formerly Visx S4) Custom treatment did not, and the manufacturer included this statement".
•"Although the WaveScan WaveFrontB System measures the refractive error and wavefront aberrations of the human eyes, including myopia, hyperopia, astigmatism, coma, spherical aberration, trefoil, and other higher order aberrations through sixth order, in the clinical study for this PMA, the average higher order aberration did not decrease after CustomVueTM treatment."
(FDA approval order P930016/S16)
•"Although the WaveScan WaveFront®' System measures the refractive error and wavefront aberrations of the human eyes, including myopia, hyperopia, astigmatism, coma, spherical aberration, trefoil, and other higher order aberrations through sixth order, in the clinical study for this PMA, the average higher order aberration increased after CustomVue treatment. The most noticeable increases were in coma and spherical aberration."
(FDA approval SSED P930016/S021)"
Misconception #3
The most commonly used laser is always the best
While it is true that the AMO Star (formerly Visx S4) has the largest market share, it is also one of the oldest lasers in the market. Like an expensive car, you don't buy one of these every couple of years. A good indicator of what surgeons believe to be the better laser system is which laser is currently the most frequently sold. The Wavelight Allegretto is currently the best selling laser in North America. See items #1 and #2 to see why more surgeons are choosing the Allegretto than any other laser.
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