Topography-Guided LASIK

Wavelight LASIK diagram

Topography-Guided (TG) LASIK and LASEK/PRK (also known as Contoura LASIK) procedures are the newest advances in laser vision correction.

Here at the Cornea and Laser Eye Institute – Hersh Vision Group we are using the new Wavelight Allegretto Eye-Q laser to perform this type of LASIK; the goal of these procedures is to be even more precise than with previous technologies, to optimize your visual results, and to help avoid night vision side effects such as glare or haloes around lights.

How does it work?

All of our LASIK procedures use what’s known as wavefront optimization. This is based on the technology used by astronomers to sharpen the image of distant objects that may have been distorted, for instance, by the earth’s atmosphere.

However, aside from nearsightedness or astigmatism, vision can also be affected by other individual optical irregularities or aberrations. These aberrations can be thought of as static light, which lessens the clarity of the signal or image. This is analogous to everyday TV use. For instance, a high definition TV has a more focused signal and less static or aberrations, and thus a crisper picture.

The same is true for your eye. Each eye has a unique aberration profile which remains even if nearsightedness and astigmatism are corrected. After LASIK, specific aberrations or visual static components can potentially affect night vision, with symptoms such as glare and halo images.

Minimizing or correcting these aberrations will, we hope, make your vision correction more precise, whether done by a LASIK or LASEK/PRK technique.

The Wavelight laser that we use was developed to incorporate wavefront principles into each procedure by adjusting the laser treatment for the patient’s specific corneal curvature. Specifically, the laser algorithm adjusts for your “spherical aberration” based on your individual prescription and corneal curvature.

In addition to this correction, in TG-LASIK, we also program your individual corneal map into your laser treatment. The corneal topography map is like a map of a mountain range taken from a satellite – red areas are higher (like a mountain), blue areas are lower (like a lake), and the green represents a normal slope.

By programming your map directly into the laser, our goal is to further remove optical irregularities from your cornea and give you an even better corneal shape with, consequently, improved visual function. TG-LASIK is not for everyone and we will need to evaluate your particular situation to see what’s your best option in vision correction surgery.

Individual topography map is incorporated into LASIK eye surgeryThe Orange area shows astigmatism with some irregularity.  Topography-guided LASIK helps to smooth these irregularities with the goal of improving the quality of vision.

Topography-guided LASIK procedure

Individual topography map is incorporated into the laser treatment in the topography-guided LASIK procedure

The Wavelight Allegretto Eye-Q Laser

With a repetition rate of 400 pulses per second, the Wavelight Allegretto Eye-Q laser is one of the fastest available in the world today. In addition, an integrated high-speed eye-tracker assures that each spot of the treatment is placed in exactly the right spot, even if you move your eye.

The Wavelight laser also features a new approach to laser vision correction. Most current laser systems may leave the eye with increased spherical aberration, which degrades the quality of vision, especially at night, and may cause the glare and halo phenomenon.

The Wavelight laser adjusts the treatment based on individual curvature measurements, with the hope of minimizing spherical aberration and improve vision quality both during the day and night.

The Wavelight laser affords an optimized energy stability control. This program automatically balances the energy levels during the treatment to ensure that every laser pulse (of thousands in a treatment) creates the same result.

In addition, the Wavelight laser utilizes a small beam diameter. This allows for proper treatment of the smallest curvatures of the cornea and results in a very smooth postoperative corneal surface.

The Wavelight laser also appears to be advantageous in treating patients with large pupils. This is because of the optimized shaping of the periphery of the corneal treatment as well as the larger treatment zone sizes that can be used if necessary.

Thus, the risk of glare and halo at night, while not eliminated, may be minimized. All in all, these many Wavelight features and advancements seem to offer advantages to laser vision correction. In fact, studies that we have done at CLEI demonstrate improved results using this technology.

Contoura Vision

Here at The Cornea and Laser Eye Institute, Dr. Peter Hersh is pleased to be one of the first centers in the country to perform topography-assisted custom ablation laser treatments (Contoura Vision) for patients with nearsightedness or astigmatism and selected patients with Keratoconus. We have some of the most extensive topography-guided LASIK experience in the U.S.

Contoura Vision is a topography-guided LASIK treatment intended to provide patients an even more customized laser vision correction procedure.

It achieves this by utilizing corneal topography data analyzed by the Allegro Vario Topolyzer, a new instrument that can measure the individualized curvatures of your cornea (the clear, dome-like, watch glass of your eye).

The cornea then is reshaped according to your proper prescription as determined during your measurement examination and, also, is optimized for your individual corneal shape map.

This procedure is performed using the all-laser LASIK technique that has given patients safe and excellent vision results for years.

Studies have shown that topography-assisted LASIK may achieve an even better vision in selected patients. Contoura Vision treatment may benefit patients up to -8.0 diopters of nearsightedness and up to -3.0 diopters of astigmatism.

Topography-assisted LASIK is not for everybody, and we will determine the procedure to best correct your vision on the basis of your examination.

PRK Surgery example

To see if Contoura Vision is the best procedure for you, contact us at 201-692-9434 or to set up a complimentary consultation today.

The Cornea and Laser Eye Institute is located in Teaneck, New Jersey, an easy commute from Paramus, Morristown, Bedminster, and Princeton, and is located conveniently for LASIK patients across the bridge in Manhattan, New York City, Westchester, and Connecticut.

Our NJ LASIK patients are encouraged to visit our office and have their questions answered personally.


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Thank you so much Doc! When I first came to you I was 20/50 now I'm 20/10. I'm ready to have a great year!

Randy Foye
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My experience at The Cornea and Laser Eye Institute has been amazing. All of the staff have been helpful and courteous...

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Dr. Hersh and his staff were excellent. I was comfortable from the time I walked in until the time I left after the procedure.

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