This quote is taken off of the packet of imformation my doctor gave me before my procedure...

"...we use our own nomogram software to customize the laser programming..."

Is this the custom ablation that everyoe is talking about? If not, what is it?

Janine,

The notion that the laser is programmed to laser your eyes as unique eyes is incorrect. The treatment you receive will not be customized to you. Your prescription is plugged into the laser, which uses the nomogram to determine the amount of ablation you will receive.

Nomograms are averages, based on outcomes data from previous patients. Doctors can obtain nomograms from the laser manufacturers, but they are just averages for groups of patients. Each doctor does LASIK in their own manner, and little differences in technique will alter their outcomes. As a doctor does more and more laser treatments, they can compile their own nomogram. These are preferable to using another surgeon's nomogram, but it is by no means custom ablation.

I had this argument with a LASIK surgeon who started advertising on the radio that they perform "customized" LASIK. This surgeon purchased a computer program to try to tweak his results - as the results can be affected by such factors as the humidity on that day, the temperature in the room, and other small factors that may or may not be taken into account. In general, the customization program may provide a slight improvement in the overall results, and this is something that my practice is looking into.
But in general -customized LASIK refers to the laser taking data from wither wavefront scans of the eye or atleast dopography data to provide a customized treatment of the cornea.

Bill Trattler, MD
Miami, FL