I am 9 years out from lasik with a first-generation laser. I now plan to have enhancement using PRK. With the understanding that early lasik procedures induced high-order aberrations, would I be better off using the VISX custom wavefront technology, over the Alegretto wavefront optimized technology?

what is your pescription now? If its low, a thin pair of glasses part time may be the better option than risk surgury all over. Also the risk of overcorrection is there like what happened to Pat and others. If you do decide to get more lasik, do only one eye at a time.

I use the VISX platform, and surface ablation over the flap does work very nicely for patients. Obviously as with eveyrthing in life - there are risks with surgery. But overall, in my experience, my patients, have done very well when they have undergone surface ablation to enhance previous LASIK.
In these cases - one can certainly consider having treatment in just one eye. But most patients do want to have both eyes treated on the same day, and you should discuss this issue with your doctor.
Finally - there may be some advantages to a true wavefront-guided enhancement (VISX) vs a wavefront-optimized treatment (Wavelight). But I have not seen any data on this type of comparison.
I should add that we had excellent results when performing standard ablations (not wavefront) with the VISX and Autonomous over the flap, so I would expect that on average both VISX and wavelight platforms would provide solid results.

I hope this helps

Bill Trattler, MD
Miami, FL

I use the VISX platform, and surface ablation over the flap does work very nicely for patients. Obviously as with eveyrthing in life - there are risks with surgery. But overall, in my experience, my patients, have done very well when they have undergone surface ablation to enhance previous LASIK.
In these cases - one can certainly consider having treatment in just one eye. But most patients do want to have both eyes treated on the same day, and you should discuss this issue with your doctor.
Finally - there may be some advantages to a true wavefront-guided enhancement (VISX) vs a wavefront-optimized treatment (Wavelight). But I have not seen any data on this type of comparison.
I should add that we had excellent results when performing standard ablations (not wavefront) with the VISX and Autonomous over the flap, so I would expect that on average both VISX and wavelight platforms would provide solid results.

I hope this helps

Bill Trattler, MD
Miami, FL