Eyeworld

52 | EYEWORLD | SUMMER 2026 R EFRACTIVE by Liz Hillman Editorial Co-Director About the physicians Arthur B. Cummings, MD, MMed, FCS(SA), FRCSEd Medical Director Wellington Eye Clinic Associate Clinical Professor University College Dublin Dublin, Ireland Mark Lobanoff, MD Founder/President OVO LASIK + LENS Minneapolis, Minnesota Karl Stonecipher, MD Medical Director Laser Defined Vision Greensboro, North Carolina Clinical Professor UNC Department of Ophthalmology Chapel Hill, North Carolina Clinical Adjunct Professor Tulane University New Orleans, Louisiana Ray tracing-guided LASIK and the WaveLight Plus platform Why was—and are—technological improve- ments for LASIK important, even when the out- comes are already so good? There are several reasons, according to Arthur B. Cummings, MD, MMed, FCS(SA), FRCSEd, including the need to improve upon the percentage of people achiev- ing 20/20 and improve quality of vision. Dr. Cummings said ray tracing-guided LASIK with WaveLight Plus (Alcon) is the only technology to date that has been shown to reduce existing ocular aberrations, specifically spherical aberra- tion; other technologies have improved in that they induce fewer of these aberrations but don't reduce them. Ray tracing-guided LASIK, Dr. Lobanoff said, "threads the needle between all the differ- ent procedure types." WaveLight Plus creates a digital model of each individual patient's eye using biometry, a wavefront analyzer, and a tomographer. The WaveLight Plus planning ecosystem, including the Sightmap diagnostic device, connects with the WaveLight EX500 excimer laser platform. I f refractive surgeons—and the industry that supports them—had a motto, it probably would be to never settle. Just look at the evolution of LASIK treatment planning eco- systems and treatment refinements—tradi- tional, wavefront-guided, wavefront-optimized, topography-guided, and ray tracing. The history, as put forth by Mark Lobanoff, MD, began with traditional LASIK. Then engi- neers devised wavefront-guided systems to treat the cornea based on wavefront exams. This worked well for about 30% of patients. Then came wavefront-optimized, which Dr. Lobanoff said was a "huge hit and did incredibly well," but was "still leaving meat on the bone." That "meat" being quality of vision because it wasn't treating higher order aberrations. This is when topography-guided treatment approaches, such as Contoura (Alcon), were developed to address most higher order aberrations. "Contoura with Phorcides planning de- livered the best visual outcomes of any LASIK platform, however, it was complicated," Dr. Lobanoff said. You needed the Phorcides soft- ware, two topographers, and the planning stage was complex. The evolution of LASIK treatment planning Performing the first FDA-approved WaveLight Plus surgery in the U.S. at OVO LASIK + LENS Source: Mark Lobanoff, MD

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