Modern excimer laser platforms utilise wavefront-optimized or topography-guided algorithms to minimise induction of higher-order aberrations.
Earlier generations of laser refractive surgery were associated with increased spherical aberration and night vision symptoms. However, contemporary studies demonstrate significant reduction in aberration induction compared with early systems¹.
Enhancement procedures, when appropriately centred and performed with adequate optical zone size, do not typically worsen night vision quality. Wavefront-optimized LASIK outcomes show maintained contrast sensitivity and low induction of higher-order aberrations².
In pseudophakic patients with multifocal or extended depth of focus intraocular lenses, corneal laser refinement has been shown to improve uncorrected acuity without increasing dysphotopsia when residual refractive error is small³.
Patient counselling remains important. Very large optical zone enlargement is not always possible in thin corneas.
Enhancement aims to refine the optical system, not disturb it.
When biomechanical and centration principles are respected, enhancement preserves night driving performance and visual comfort.
References
- Moshirfar M, McCaughey MV, Santiago-Caban L, et al. Higher-order aberrations after laser refractive surgery. Curr Opin Ophthalmol. 2015;26(4):260-265.
- Schallhorn SC, Venter JA, Hannan SJ, et al. Wavefront-optimized LASIK outcomes. J Cataract Refract Surg. 2015;41(2):316-322.
- Alfonso JF, Fernández-Vega L, Baamonde MB, et al. LASIK after multifocal IOL implantation. J Cataract Refract Surg. 2008;34(6):1023-1028.
Related Topics
- Does an Enhancement After Laser or Lens Replacement Surgery Mean Something Went Wrong?
- What Is a Laser Eye Surgery Enhancement?
- How Common Is Enhancement After LASIK?
- Why Are Higher Prescriptions More Likely to Require Enhancement?
- Why Do Hyperopic Laser Treatments Regress More Frequently?
- Why Is Residual Hyperopia After Lens Surgery Different?
- How Is LASIK Enhancement Performed?
- How Is Enhancement Performed After SMILE?
- What Is Residual Stromal Bed and Why Does It Matter?
- Can Enhancement Affect Night Vision or Optical Quality?
- When Should Enhancement Not Be Performed?
- How Long Should You Wait Before Laser Enhancement?
- What Causes Regression After Laser Eye Surgery?
- What Is Topography-Guided Enhancement?
- Can Enhancement Increase Glare or Halos?
- Why Does Astigmatism Sometimes Remain After Laser Eye Surgery?
- What Is Epithelial Remodelling and Why Does It Matter?
- Is Enhancement Safer Than Intraocular Lens Exchange?
- What Is the Risk of Ectasia After Enhancement?
- Does Enhancement Affect Long-Term Vision Quality?
- What Does an Enhancement Cost?
