The History of Laser Refractive Surgery
1 September 2015
Over the past 20 years, laser refractive surgery has become an extremely popular surgery option for patients who would like to become less dependent on their spectacles. While laser refractive surgery has only been prominent since the late 1990’s, the plans and processes that have allowed us to be able to perform these life changing surgeries have been in the works for over 60 years.
At Hunter Laser Vision, we pride ourselves on providing current and top of the range technology to provide our patients with the best quality service. Since opening our doors in 1998 we have had three different Schwind lasers and continue to monitor any updates occurring in relation to laser refractive technologies.
In 1948, Polish missionary Father Waclaw Szuniewicz is seen as one of the pioneers of laser refractive surgery with his work involving the cornea. Szuniewicz experimented with changing the shape of the corneal curvature and experimented with surgical options to accomplish this.
In 1964, Professor Jos- Ignacio Barraquer introduced keratomileusis and keratophakia after many years of investigating the modification of the cornea. Keratomileusis is a procedure that was developed to treat ametropia, an optic condition that inhibits the retina from focussing on distant objects. This procedure involved removing, modifying and reinserting the corneal disc into the patient’s eye.
Radial keratotomy was the first form of laser refractive surgery performed in 1973 by Svyatoslov N. Fyodorov, and became popular towards the late 1970’s in America. This procedure is achieved by calculating how to make radial incisions on the anterior surface of the cornea in order to change its shape.
From 1973- 1983, researchers from IBM Thomas J. Watson Research Centre in New York began to explore ways to use the excimer laser. This uses refractive gases (e.g. chlorine and fluorine), mixed with inert gases (e.g. argon and krypton). Once these gases are electrically excited, they emit energetic pulses of ultraviolet light in order to create very tiny, precise changes to irradiated material, such as polymers.
It wasn’t until 1987 that the excimer laser was first used to perform laser surgery on a patient’s eyes by Dr Steven Trokel. Trokel also introduced Photorefractive Keratectomy (PRK), a procedure performed on the surface of the eye in order to correct refractive errors such as myopia or hyperopia.
The next 10 years were spent perfecting the equipment and techniques used to perform the surgery. In 1995, PRK was approved by the Food and Drug Administration (FDA). This was closely followed by the approval of LASIK surgery in 1996. LASIK is a procedure that incorporates both previously proven flap technology combined with the use of the excimer laser to reshape the cornea.
In 2003, the FDA approved the use of the Customised Wavefront LASIK using the VISX XustomVue System, which was an entirely new generation of laser vision correction. The original goal of this technology was not to actually exceed the quality of vision that would normally have been achieved through glasses or contact lenses.
Today, PRK and LASIK are still both very prominent surgery types used in laser refractive surgeries around the world. Since the introduction of the first laser in the 1980’s, there have been significant advances in the technology used to perform laser refractive surgery.