By Jeffrey B. Minkovitz, M.D.
For over three decades, laser vision correction has helped millions of people reduce or eliminate their dependence on glasses and contact lenses. Technology has steadily improved—with faster lasers, better tracking, and increasingly customized treatments. But occasionally an advance goes beyond incremental improvement. Ray-tracing–guided customized laser vision correction, as used in Alcon’s WaveLight Plus LASIK treatment, is one of those advances.
Traditional laser vision correction begins largely with the same measurement used to prescribe glasses: the eye’s refractive error. More sophisticated systems added measurements of the cornea and other optical imperfections.
SightMap ray-tracing technology takes personalization to another level, gathering far more detailed information about the individual eye to design and guide treatment.
In a prospective, randomized study published in Ophthalmology, 100% of eyes treated with WaveLight Plus LASIK achieved 20/20 or better uncorrected vision three months after treatment, and 83% achieved 20/16 or better. Another two-year study found that 65% gained at least one line of vision beyond their best corrected vision before surgery, and 38% gained two lines. Another real-world study of ray-tracing-guided LASIK found roughly half achieved 20/12.5 or better—sharper than the 20/20 standard many associate with “perfect” vision.
Of course, no technology can guarantee a particular result for every patient. Outcomes depend on each patient’s eyes, prescription, and appropriate patient selection.
So what makes this technology different?
SightMap collects more than 100,000 data points describing the eye’s optical characteristics. Ray tracing uses those measurements to construct a three-dimensional virtual model and mathematically trace how light travels through the eye. Rather than simply treating a glasses prescription, treatment is calculated from the patient’s unique optical system, including the cornea, anterior chamber, and natural lens.
The result is a highly individualized treatment plan—essentially an optical “digital twin” of the eye that is used to design the laser treatment.
This matters because our goal is no longer simply 20/20 on an eye chart. We increasingly seek excellent quality of vision as well: sharpness, contrast, night vision, and reduction of subtle optical imperfections that glasses cannot correct.
WaveLight Plus received FDA approval in the United States in 2025 for specified LASIK treatments of nearsightedness and astigmatism. The underlying WaveLight EX500 excimer laser platform is FDA-approved for both LASIK and PRK, and is the same platform used for WaveLight Plus LASIK with SightMap. Use of the newer WaveLight Plus ray-tracing treatment with PRK is currently off-label, and the LASIK results described above have not yet been independently established for PRK.
After 30 years of refractive surgery—including approximately 10 years performing LASIK—I have long favored PRK for most patients. PRK provides excellent accuracy and visual outcomes without creating a permanent corneal flap, eliminating flap-related complications and reducing concerns such as dry eye and corneal ectasia in susceptible eyes. It is also appealing for active lifestyles because there is no flap vulnerable to later trauma. The tradeoff is slower recovery and sometimes several days of greater discomfort, so treatment should be individualized.
After three decades performing laser vision correction, I have experienced many generations of technology. Improvements are expected; transformative advances in how we measure, model, and optimize the optics of an individual eye are rare. Ray tracing represents an exciting next step in personalized vision correction.
Bio
Dr. Jeffrey Minkovitz specializes in corneal, cataract, and refractive surgery and has been a partner at Eye Physicians and Surgeons, P.A. since 1996. A Harvard graduate, he received his medical degree from the University of Massachusetts, served his ophthalmology residency at Washington University, and completed a cornea and refractive surgery fellowship at the Wilmer Eye Institute of Johns Hopkins. Later, as a clinical instructor at Johns Hopkins, he received the Outstanding Teacher Award.
He is one of only a few Delaware surgeons trained in corneal transplantation and performs advanced cataract surgery, including laser-assisted cataract surgery and advanced-technology lens implants. Dr. Minkovitz is known for several Delaware firsts, including PRK laser vision correction and newer, less-invasive techniques for corneal transplantation. He co-founded the Center for Advanced Surgical Arts, helped bring laser cataract surgery to Delaware, and founded Laser Vision Delaware, LLC. In 2026, he introduced advanced ray-tracing technology to Delaware for highly precise, personalized laser vision correction. For further information or to schedule an appointment please call 302-652-3353.
