iDesign® LASIK vs Contoura® Vision LASIK: What’s the Difference?

When it comes to gaining independence from eyeglasses or contact lenses, the first thing that comes to most people’s minds is the LASIK vision correction procedure.

But in case you didn’t know, not all LASIK technologies are the same. As a result, it’s vital to understand the advanced technology options available so you can make an informed decision about your eye health.

Two of the most advanced and precise technologies for vision correction laser surgery are iDesign® (also called Wavefront LASIK) and Contoura® Vision. Both aim to provide highly personalized treatments tailored to the unique characteristics of each patient’s eyes, but they have some notable differences.

After reviewing the technologies, Assil Gaur Eye Institute (AGEI) has chosen to use the iDesign from Johnson & Johnson. Since many of our patients ask about the difference in these technologies, here’s a quick comparison between iDesign and Contoura Vision!

What are iDesign and Contoura Vision?

iDesign (also known as iDesign Refractive Studio and Wavefront-Optimized LASIK) is an advanced wavefront-guided LASIK technology that maps the entire optical system of the eye, providing a highly detailed 3D map. This technology measures and records imperfections in the way your eye processes images with more than 1,200 data points — five times more than the previous wavefront-guided techniques.

By doing so, iDesign allows for a highly personalized LASIK surgery that’s tailored to not just your cornea’s shape and curvature, but your entire optical pathway.

This technological advancement ensures that each eye surgery is uniquely customized to the patient, potentially improving not only how much you can see but also how well you can see in terms of contrast sensitivity and fine details.

Contoura Vision (also known as Contoura LASIK and Topography-Guided LASIK) takes a different approach. It uses a detailed map of the cornea’s surface, capturing up to 22,000 elevation points of the patient’s corneal tissue.

Topography-guided Contoura Vision LASIK focuses primarily on correcting the cornea’s irregularities to enhance the quality of the vision. By precisely altering the shape of the cornea, Contoura Vision is especially beneficial for patients with unique corneal irregularities and those who want to correct their vision problems and improve the quality of their vision.

What are the key differences between iDesign and Contoura Vision?

The main difference between these two technologies is how each analyzes the patient’s eye for vision correction. These include:

What do iDesign and Contoura Vision technologies measure?

iDesign assesses the patient’s entire optical system, which is a key reason that AGEI has chosen it.

Contoura Vision Topography-Guided LASIK focuses on the cornea’s surface irregularities (topography), which is an important component of vision correction, but not the only important aspect.

However, the iDesign Refractive Studio system, launched and FDA-approved in 2019, offers a highly personalized treatment by analyzing the entire eye, both internally and externally, using a combination of topography-guided and wavefront-guided technology.

What data points do iDesign and Contoura Vision collect?

iDesign uses over 1,200 data points to map the eye’s optical system, whereas Contoura Vision captures up to 22,000 points of the cornea alone.

How customizable are iDesign and Contoura Vision?

Both technologies offer a high degree of customization for custom LASIK, but approach it from different angles. iDesign uses a holistic view of the eye’s optical system, while Contoura Vision’s topography-guided treatment only focuses on the cornea.

iDesign and Contoura Vision use different laser  technologies

Beyond the different ways the iDesign and Contoura Vision systems measure your eye for laser vision correction, they also utilize different laser systems.

The STAR S4 IR® Excimer Laser System, which, in combination with the iDESIGN® Refractive Studio, is indicated for wavefront-guided laser-assisted in situ keratomileusis (LASIK) procedures.

Contoura uses Alcon’s WaveLight Allegretto Wave Eye-Q or WaveLight EX500 Excimer Laser Systems in concert with the WaveLight Topolyzer Vario Diagnostic Device.

	Contoura	iDesign Wavefront
Conditions treated	Nearsightedness (myopia) and astigmatism	Nearsightedness (myopia), farsightedness (hyperopia), astigmatism
Success rate	Nearly 65% get 20/16 vision or better; nearly 93% get at least 20/20 vision	Wavefront LASIK produces 20/16 vision or better in the majority of patients
Patient qualification	Stable nearsightedness and astigmatism prescriptions; thinner corneas and sharp corneal angles accepted in most cases	Stable prescriptions, not having tiny pupils
Surgery technique	Detailed corneal measurements make the procedure fully customized	A 3D map of the cornea made before surgery guides the process as the data is entered into the laser
Recovery time	24 hours to resume normal activity	24 hours to resume normal activity
Potential side effects	Glare, halos, ghosting images, and blurring as tissues heal, dry eye	Side effects like itching and discomfort are mild and tend to fade as the eyes heal, dry eye

Clinical studies on iDesign and Contoura Vision show good, but different, results

Both iDesign and Contoura Vision have been subject to numerous clinical studies and have demonstrated efficacy and safety in improving vision as well as high patient satisfaction.

Research studies provide substantial evidence supporting the efficacy and safety of the iDesign system for refractive surgery, including:

Prospective study on Wavefront-guided PRK with iDesign

A study detailed on ClinicalTrials.gov evaluated the safety and effectiveness of wavefront-guided PRK (Photorefractive Keratectomy) for myopic refractive errors using the iDesign Advanced Wavescan Studio™ System.

This non-randomized clinical trial was conducted across multiple centers and involved 167 participants. The study found that 100% of patients achieved visual acuity of 20/40 or better at six months postoperative, indicating a high success rate for vision correction with the iDesign system.

FDA approval of iDesign Refractive Studio

The FDA’s approval of the iDesign Refractive Studio underscores its safety and effectiveness for customized LASIK treatment.

It is notably the only system approved for monovision LASIK in presbyopic patients, indicating its versatility in addressing different refractive errors. The majority of patients in clinical studies achieved 20/16 vision or better six months post-operation, highlighting the system’s ability to deliver superior visual outcomes​.

Comparing iDesign to the SMILE procedure

A study conducted by Narayana Nethralaya compared the iDesign technique with the SMILE (Small Incision Lenticule Extraction) procedure for correcting myopia with astigmatism. This randomized clinical trial suggests that iDesign may provide equivalent or better outcomes than SMILE by removing less tissue and correcting higher-order aberrations.

The study posits that iDesign’s comprehensive treatment plan, including higher-order aberrations correction, could result in better short and long-term outcomes compared to SMILE, which only corrects lower-order aberrations.

In closing, is one technology truly better than the other?

Research comparing iDesign vs Contoura vision LASIK technologies is nuanced, with different studies emphasizing various aspects such as visual acuity outcomes, contrast sensitivity, and patient satisfaction.

For example, one study might highlight the superior visual outcomes of one technology over the other in specific circumstances or patient groups​ (ResearchGate). Another comparison indicated that the other had higher rates of patients achieving better than 20/20 vision if they had certain severe or unusual conditions (Alcon).

The choice between the two may sometimes depend on the specific preferences of the surgeon. Some surgeons may prefer one technology over the other based on their experience, familiarity, and the results they’ve seen with their patients versus conventional LASIK. Assil Gaur Institute prefers iDesign and has had superior outcomes with this technology.

Ultimately, both iDesign and Contoura Vision are advanced LASIK procedure technologies that aim to provide customized laser vision correction with high precision and greatly improved outcomes compared to traditional LASIK.

Contact Assil Gaur Eye Institute: leaders in LASIK technology

Assil Gaur Eye Institute of Los Angeles has assembled a team of top ophthalmologists from around the country who offer their patients the highest quality specialist eye care in the United States.

At AGEI, we pride ourselves on offering the most advanced surgical techniques and state-of-the-art LASIK technology. We provide our patients with the safest, most effective procedures designed to optimize their experience and visual outcomes.

We also offer unrivaled postoperative LASIK follow-up care. Though problems are very rare with our patients, it is critically important to catch and address any issue expediently, no matter where you have your surgery performed.

Please call (866) 945-2745 or make an appointment online.

We are conveniently located for patients throughout Southern California and the Los Angeles area in or near Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.

Sources:

Jain, Arun Kumar, et al. “Outcomes of Topography-Guided versus Wavefront-Optimized Laser in Situ Keratomileusis for Myopia in Virgin Eyes.” Journal of Cataract & Refractive Surgery, 2016.

Lin, Y., Su, H. J., Yuan, M. Z., & Zhang, Y. (2022). Vector analysis of Contoura Vision for the correction of myopia and myopic astigmatism. International journal of ophthalmology, 15(6), 983–989. https://doi.org/10.18240/ijo.2022.06.17

Lobanoff, M., Stonecipher, K., Tooma, T., Wexler, S., & Potvin, R. (2020). Clinical outcomes after topography-guided LASIK: comparing results based on a new topography analysis algorithm with those based on manifest refraction. Journal of cataract and refractive surgery, 46(6), 814–819. https://doi.org/10.1097/j.jcrs.0000000000000176

Ozulken K, Yuksel E, Tekin K, Kiziltoprak H, Aydogan S. Comparison of Wavefront-Optimized Ablation and Topography-Guided Contoura Ablation With LYRA Protocol in LASIK. J Refract Surg. 2019 Apr 1;35(4):222-229. doi: 10.3928/1081597X-20190304-02. PMID: 30984979.