How Lasik Came to Be


Some people believe that the use of Lasik procedures has only occurred in very recent times. To most people Lasik and its associated technology are still novel concepts. However, Lasik's success is the result of improvements made on prior procedures.

Vision correction surgeries can be traced back over fifty years to when some of the first procedures were carried out. In 1948, Dr. Jose Barraquer developed a technique we would describe as barbaric and unethical by today's health care standards. Dr. Barraquer, who practiced in Bogota, Columbia, would remove and then freeze more than 50% of the patient's cornea. A lathe would then be used to carefully sculpt the surface of the cornea to increase the quality of vision. The cornea was then sewn back in place once it was redesigned.

The outcomes of this technique, which was known as MKM, or freeze myopic keratomileusis, were extremely variable and thus clinically unreliable. It could also be a very complicated and intricate surgery to perform. The technique seems barbaric, but Lasik's history is dependent upon the knowledge gained from those who came before. Today's Lasik can thank MKM's use of the basic version of microkeratome for advances in the industry.

Helping the development of the concept of vision correction was the understanding of some of the problems surrounding MKM. ALK was created over a decade later. To correct refractive errors, this technique used a modified microkeratome to create a flap at the front of the eye and then removed a wedge of corneal tissue. As happend with Doctor Barraquer's way of performing the surgeries, the effects of ALK could not be guaranteed.

Not long after the development of the automated lamellar keratoplasty method, a procedure known as radial keratotomy, or RK, was invented by a Russian physician. Doctor Fyodorov modified the prior procedure a little to produce more consistent results with a higher percentage of successful vision corrections. In an RK procedure, the cornea is sculpted using common, non-specialized surgical tools. Reshaping the cornea involved removing portions of the cornea in order to correct refractive errors, myopia (nearsightedness), and astigmatism.

Doctor Fyodorov's RK technique was more difficult but produced better results. However, it still produced poorer results than today's Lasik. His results were more reliable than previous techniques but still useless for refractive errors other than astigmatism or slight problems with nearsightedness.

For thirty years after Dr. Fyodorov's technique was applied to use in the eye, lasers were developed and used in correcting eye problems. The use of the excimer laser for the removal of corneal tissue was first described by the Steven Trokel in 1983. The laser was used in a procedure known as photorefractive keratectomy, which can now be used to treat up to 80% of the myopic population. PRK changes the shape of the anterior central cornea using a laser. PRK preceded the invention of Lasik, which affects the inner tissue of the cornea.

Lasik surgeries first appeared in 1991 when the procedure was first carried out in the United States. With this technique, predictable and accurate outcomes could be achieved for the first time. The first surgery to offer a speedy and often pain free surgery, Lasik can also boast a very short recovery period. Lasik's past has been a meaningful aid to the procedures we have today.