If you’ve started researching LASIK, you’ve probably met a list of names: wavefront-optimised, wavefront-guided, topography-guided, Contoura, Phorcides, ray tracing. They’re all ways of planning the pattern the laser uses to reshape your cornea. This guide explains what each one means, what the studies show, and how we choose between them at Focus Vision.

Short answer: all modern options give excellent results. Topography-guided LASIK uses a detailed map of your cornea and, in published studies, gives slightly more accurate results and fewer new optical imperfections than wavefront-optimised LASIK. At Focus Vision we offer wavefront-optimised, topography-guided LASIK planned with Phorcides, and Ray Tracing LASIK, choose the one that suits your eyes, and don’t charge more for any of them.

TreatmentWhat the plan is based onAt Focus Vision
Wavefront-optimisedYour glasses prescription, with a profile designed not to add new imperfectionsYes
Wavefront-guidedA measurement of the optical imperfections of the whole eyeNot offered; it uses a different laser platform
Topography-guided (Contoura)A detailed map of the shape of your corneaYes, planned with Phorcides
Ray tracingA virtual model of your whole eye built from several scansYes; the only clinic in Queensland offering it

All four are LASIK on the same principle: a thin flap, then an excimer laser reshapes the cornea underneath. What differs is how the laser pattern is calculated.

Why “custom” LASIK exists

Your glasses prescription describes short-sightedness, long-sightedness and astigmatism. These are called lower-order errors. Every eye also has small optical imperfections that glasses can’t correct, called higher-order aberrations, which can affect the quality of vision, especially at night.

Early laser treatments sometimes added new higher-order aberrations. Modern planning methods aim to avoid that, and some aim to reduce the aberrations you already have (Li et al., Cochrane 2020). The other question is which astigmatism to treat: the astigmatism in your glasses prescription and the astigmatism on the surface of your cornea don’t always match, and different planning methods handle that differently.

Wavefront-optimised and wavefront-guided LASIK

Wavefront-optimised treatments correct your glasses prescription using a laser profile designed to minimise new higher-order aberrations while preserving the eye’s natural ones. Wavefront-guided treatments are planned from a measurement of the higher-order aberrations of the whole eye (Li et al., Cochrane 2020).

A Cochrane review of 33 randomised trials found no important difference between wavefront-optimised and wavefront-guided surgery, or between wavefront and conventional surgery, in the clinical outcomes studied (Li et al., Cochrane 2020). Wavefront-optimised treatment is the standard profile on the Alcon WaveLight EX500 laser we use for LASIK, and it gives excellent results for most eyes with a regular cornea.

Topography-guided LASIK (Contoura)

Topography-guided treatment starts from a detailed map of the front surface of the cornea, built from thousands of elevation points, so the laser can treat irregularities in the corneal shape as well as your prescription. These treatments are associated with better contrast sensitivity and less induction of new higher-order aberrations (İpek & Utine, 2024). Contoura Vision is Alcon’s topography-guided treatment on the WaveLight platform.

What the studies show:

  • In the US clinical trial of topography-guided LASIK (249 eyes), uncorrected vision after surgery was at least as good as the best vision with glasses before surgery in 90% of eyes, 30% saw at least one line better than they had with glasses, and most visual symptoms improved (Stulting et al., 2016).
  • A meta-analysis of seven randomised trials (1,168 eyes) found the same chance of 20/20 vision after topography-guided and wavefront-optimised LASIK, but topography-guided treatment gave more accurate prescriptions and fewer new higher-order aberrations, spherical aberration and coma (Cheng et al., 2021).

Phorcides: planning topography-guided LASIK

Phorcides is surgical planning software for topography-guided LASIK, developed by Minnesota ophthalmologist Dr Mark Lobanoff. Rather than simply treating the astigmatism in your glasses prescription, it analyses your corneal map to work out the treatment. Studies of Contoura planned with Phorcides on the WaveLight laser report excellent results:

  • 640 eyes, four US clinics: 62.5% of eyes planned with Phorcides saw 20/16 or better without glasses, compared with 41.3% of eyes treated from the glasses prescription; residual prescriptions were similar (Lobanoff et al., 2020).
  • 130 eyes, prospective study on the WaveLight EX500: at three months, 100% of eyes saw 20/20 or better and 89% saw 20/15 or better without glasses. No eye lost more than one line of vision, and glare, halos, night driving difficulty and starbursts all decreased (Stulting et al., 2022).
  • Oblique astigmatism, 197 eyes: compared with wavefront-optimised LASIK, Phorcides-planned treatment left less astigmatism, more eyes reached 20/16 (36% vs 22%), and none needed an enhancement compared with five after wavefront-optimised treatment (Brunson et al., 2022).
  • 348 eyes, single centre, WaveLight EX500: both approaches gave excellent results, but 57% of Phorcides-planned eyes saw 20/16 or better without glasses, compared with 17% after wavefront-optimised treatment (Rowen et al., 2024).

As with most newer technology, much of this research comes from experienced centres reviewing their own results, and future randomised trials will add to the picture. What’s already clear is that modern LASIK of every type gives excellent results.

Ray Tracing LASIK

Ray tracing goes a step further. It builds a virtual model of your eye from corneal tomography, eye length and wavefront measurements, then calculates the treatment by tracing rays of light through that model. Focus Vision is the only clinic in Queensland offering Ray Tracing LASIK.

  • In a randomised study in which 30 patients had ray-tracing LASIK in one eye and wavefront-optimised LASIK in the other, 100% of ray-tracing eyes finished within 0.50 dioptres of target (90% with wavefront-optimised), and 100% saw 20/20 or better (93.3%), with the treatment planned entirely from objective measurements (Khoramnia et al., 2025).
  • In an international study of 212 eyes, 98.1% saw 20/20 or better at three months and 99.1% of patients were satisfied (Kanellopoulos et al., 2024).

See Ray Tracing LASIK for how it works and who it suits.

Which one is right for you?

There isn’t a single best treatment for every eye. Your surgeon looks at:

  • The shape of your cornea. A regular cornea often does very well with wavefront-optimised treatment; asymmetry or irregularity favours topography-guided treatment.
  • Whether your astigmatism adds up. When the astigmatism on your cornea and in your glasses prescription differ, the planning method matters more.
  • The optical quality of your eye, measured on your scans.
  • Your prescription and corneal thickness, which also decide whether LASIK, CLEAR, TransPRK or an implantable contact lens suits you best. See types of laser eye surgery.

At Focus Vision, LASIK is performed on the Alcon WaveLight EX500, which offers all three planning methods. Your surgeon chooses wavefront-optimised, topography-guided with Phorcides or Ray Tracing LASIK based on your measurements, not on price. If you have a lot of astigmatism, our guide to laser eye surgery for astigmatism covers your options in more detail.

Do these cost more?

No. At Focus Vision, LASIK is $4,250 per eye whether it’s wavefront-optimised, topography-guided with Phorcides or Ray Tracing LASIK, all-inclusive except prescribed eye drops. We don’t charge more for astigmatism or higher prescriptions either, and enhancements are free for two years under our enhancement policy. Interest-free plans start from $41 a week. See the costs page.

Book a free assessment

Your free assessment with our optometrist includes the corneal topography, tomography and other scans used to plan your treatment. If LASIK suits you, you then see Dr Brendan Cronin or Dr David Gunn, who explain which planning method they recommend for your eyes and why; the consultation fee comes off your surgery price.

Call (07) 3239 5005, email hello@focusvision.com.au or book online.

References

  1. Li SM, Kang MT, Wang NL, Abariga SA. Wavefront excimer laser refractive surgery for adults with refractive errors. Cochrane Database Syst Rev. 2020;12(12):CD012687. pubmed.ncbi.nlm.nih.gov/33336797
  2. İpek ŞC, Utine CA. Topography-guided excimer laser ablation in refractive surgery. Front Ophthalmol. 2024;4:1367258. pubmed.ncbi.nlm.nih.gov/38984110
  3. Stulting RD, Fant BS; T-CAT Study Group. Results of topography-guided laser in situ keratomileusis custom ablation treatment with a refractive excimer laser. J Cataract Refract Surg. 2016;42(1):11-18. pubmed.ncbi.nlm.nih.gov/26948773
  4. Cheng SM, Tu RX, Li X, et al. Topography-Guided Versus Wavefront-Optimized LASIK for Myopia With and Without Astigmatism: A Meta-analysis. J Refract Surg. 2021;37(10):707-714. pubmed.ncbi.nlm.nih.gov/34661478
  5. Lobanoff M, Stonecipher K, Tooma T, et al. Clinical outcomes after topography-guided LASIK: comparing results based on a new topography analysis algorithm with those based on manifest refraction. J Cataract Refract Surg. 2020;46(6):814-819. pubmed.ncbi.nlm.nih.gov/32176160
  6. Stulting RD, Lobanoff M, Mann PM 2nd, et al. Clinical and refractive outcomes after topography-guided refractive surgery planned using Phorcides surgery planning software. J Cataract Refract Surg. 2022;48(9):1010-1015. pubmed.ncbi.nlm.nih.gov/35171146
  7. Brunson P, Mann PM 2nd, Mann PM, Potvin R. Comparison of refractive and visual acuity results after Contoura Vision topography-guided LASIK planned with the Phorcides Analytic Engine to results after wavefront-optimized LASIK in eyes with oblique astigmatism. PLoS One. 2022;17(12):e0279357. pubmed.ncbi.nlm.nih.gov/36534673
  8. Rowen SL, Tooma T, Trieu N, Hall B. Retrospective Study Comparing Topography-Guided and Wavefront-Optimized LASIK Procedures in a Single Center. Clin Ophthalmol. 2024;18:1615-1622. pubmed.ncbi.nlm.nih.gov/38860117
  9. Khoramnia R, Naujokaitis T, Blöck L, et al. Prospective intraindividual comparison of automated customized ray-tracing-guided versus wavefront-optimized LASIK. Ophthalmology. 2025;132(10):1169-1179. pubmed.ncbi.nlm.nih.gov/40482723
  10. Kanellopoulos AJ, Maus M, Bala C, et al. International Multicenter, Myopic and Myopic Astigmatism Femto LASIK, Customized by Automated Ray-Tracing Ablation Profile Calculation: A Postmarket Study. Clin Ophthalmol. 2024;18:525-536. pubmed.ncbi.nlm.nih.gov/38405105
B

Brendan Cronin

MBBS (Hons), DipOphthSci, B.Com, LLB, FRANZCO, FWCRS

Dr Brendan Cronin is a corneal, cataract and refractive surgeon and co-founder of Focus Vision in Brisbane. He is the Director of Education at the Queensland Eye Institute, completed his corneal fellowship at the Manchester Royal Eye Hospital in the UK, and teaches corneal and refractive surgery techniques to ophthalmologists internationally. He co-created the CAIRSPlan surgical planner and the free Focus Vision Refractive Outcomes Analyzer.

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