The Evolution of Laser Eye Surgery

Basic forms of eye surgery can be tracked back to the late 1890s and early 1900s. By the 1970s, doctors were researching methods on how to utilize lasers to help advance surgery. The initial form was patented by Dr. Steven Trokel in the 1980s. This method utilized the Excimer laser and the first eye surgery was performed in 1987. The Excimer laser was used to correct the cornea. The techniques and methods of this particular type of surgery have continued to evolve over the following decades and eventually the Excimer laser was better utilized for ophthalmic refractive surgery.

In the past two decades since the first laser eye surgery was completed, techniques continue to advance. Photo refractive keratectomy (PRK) was invented in the early 1980s. It utilizes the Excimer laser to remove bits of tissue from around a patient’s cornea. In 1990, two Italian doctors, Dr. Lucio Buratto and Dr. Loannis Pallikaris, developed the technique of LASIK eye surgery. This technique was based on two previous utilized techniques, PRK and Keratomileusis. Keratomileusis is the reshaping of a patient’s cornea. PRK is typically a better option over LASIK for patients with larger pupils or thin corneas.

The LASIK technique works because it reshapes the cornea to fix refractory errors that the eye is experiencing. Different types of refractive errors are myopia, hyperopia and astigmatism. Helping to further advance the LASIK technique, in 1990, Dr. Jose Barraquer of Columbia developed the Microkeratome device. This device, in conjugation with the Excimer laser, cuts flaps in the cornea which alters the cornea’s shape and therefore the patient’s vision. Most variations of LASIK on the market are based on the different types of laser ablations. Laser ablation is the method which the laser reshapes the cornea. These ablations include conventional laser eye surgery treatments, wavefront-guided treatments and wavefront-optimized treatments.

In addition to LASIK, there are additional refractive eye surgeries available. These surgeries include advance surface ablation, phakic intraocular lenses, conductive keratolasty and intracorneal ring segments. The most effective treatments for patients experiencing typical near or farsightedness is LASIK. Phakic intraocular lenses are best for patients with extreme myopia and are not candidates for LASIK or advance surface ablation. Conductive keratolasty is the best option for patients with hyperopia or presbyopia. Finally, intracorneal ring segments is best for patients with low myopia and keratoconus.