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LASIK Vision Correction Surgery Evolved from 19th Century Theory

LASIK Vision Correction Surgery Evolved from 19th Century Theory

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LASIK surgery, which has revolutionized vision correction in recent years, is an old idea that just needed some modern technology to make it possible. Originating as a theoretical concept first proposed in 1869, it evolved from procedures performed with simple surgical tools to a very popular surgery that uses extremely sophisticated computer-guided laser systems.

In 1869, Herman Snellen, the Dutch ophthalmologist who created modern-day vision charts, theorized that small incisions in the cornea could flatten it as a means of treating astigmatism. About 1885, Dutch physician L.J. Lans described keratotomy, the reshaping of the cornea with small incisions to correct nearsightedness, farsightedness, and astigmatism.

Radial Keratotomy Introduces Practical Cornea Shaping

Radial keratotomy, using a series of incisions in a pattern like the spokes of a wheel, was pioneered in the 1930s by Japanese ophthalmologist Tsutomu Sato and perfected in the 1970s by Russian scientist Svyatoslav Fyodorov. The procedure was introduced in the United States in 1978 by ophthalmologist Leo Bores.

The concept of reshaping the cornea by removing tissue rather than simply making incisions was pioneered by Jose Barraquer of Bogotá, Colombia, beginning in 1949. Using a small blade known as a microkeratome, he removed the tissue, reshaped it with the device used to shape contact lenses, and replaced it in the eye. In 1987, Barraquer protégé Luis Ruiz produced a motorized microkeratome that allowed simple cornea reshaping to be performed directly on the eye.

Laser Cornea Shaping Proposed in 1985

It was Dr. Stephen Trokel, an American research ophthalmologist, who, in 1985, first proposed using a laser beam to vaporize corneal tissue as a means of correcting vision.

The original laser vision correction surgery involved the risk of infection and other complications during the healing process. In 1990, researchers Ionnis Pallikaris and Lucio Buratto reduced those risks by using a microkeratome to cut a small flap in the outer corneal layer and work on the tissue below. This allowed them to close the flap after surgery, affording a measure of protection. Pallikaris dubbed this important variation laser in-situ keratomileusis, or LASIK.

In the 20 years since LASIK was introduced, continual improvements in computer control of surgical lasers have yielded increasingly better results. Today's LASIK surgery can be customized to the needs of each patient.

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