I need an enhancement after nine years- originally had lasik with a first-generation laser. Would a 'custom-vue' wavefront guided laser be better for me that a wavelight optimized Allegretto laser? I like the Allegretto laser, but I'm wondering if I am more likely to have significant high order aberrations, from my first lasik, that would benefit from a custom-lasik approach.

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