A study was undertaken to assess whether results of laser vision correction with the LADARVISION 193-nm excimer laser (Alcon-Autonomous technologies) can be improved with the use of wavefront analysis generated by a proprietary system including a Hartman-Schack sensor and expressed using Zernicke polynomials. A total of 82 eyes underwent LASIK in several centers with an improved algorithm, using the CustomCornea system. A subgroup of 48 eyes of 24 patients was randomized so that one eye undergoes conventional treatment and one eye undergoes treatment based on wavefront analysis. Treatment parameters were equal for each type of refractive error. 83% of all eyes had uncorrected vision of 20/20 or better and 95% were 20/25 or better. In all groups, uncorrected visual acuities did not improve significantly in eyes treated with wavefront analysis compared to conventional treatments. Higher order aberrations were consistently better corrected in eyes undergoing treatment based on wavefront analysis for LASIK at 6 months postop. In addition, the number of eyes with reduced RMS was significantly higher in the subset of eyes treated with a wavefront algorithm (38% vs. 5%). Wavefront technology may improve the outcomes of laser vision correction with the LADARVISION excimer laser. Further refinements of the technology and clinical trials will contribute to this goal.