Many people think LASIK is still a
new medical procedure, but in fact, the first LASIK procedure was performed 20 years ago.
History
The LASIK
procedure evolved from a combination of two older procedures: PRK (photorefractive keratectomy), which was developed
in the 1980s with an excimer laser that was used for computer chip manufacturing, and
keratomileusis, a procedure developed in the 1960s to treat refractive errors by mechanically removing
thin layers from the cornea using a microkeratome (or corneal shaper).
In 1990, Dr. Ioannis Pallikaris of Greece combined these two techniques. He cut a flap in the cornea, pulled
the flap back to expose the corneal bed and then reshaped the exposed surface with an excimer laser. He
discovered that one could achieve advanced precision and increased success rates, along with reduced risks
and comfortable healing.He called the procedure LASIK, which comes from laser-assisted in situ
keratomileusis.
LASIK
Today
The development and subsequent approval of LASIK as a procedure has revolutionized refractive surgery. Today,
tens of millions of people have had LASIK surgery worldwide. In Canada, approximately 90 per cent of laser
vision correction (LVC) patients undergo LASIK, while 10 per cent undergo PRK.Because of LASIK’s benefits, it
has become the “procedure of choice” for laser vision correction, with PRK being reserved for cases of thin
or soft corneas, or for patients who participate in activities with a high risk of blunt eye trauma such as
boxing.
Since LASIK was first performed in 1990, there have been many technological breakthroughs as well as safety
features that have been added.These include:
Eye
trackers:These
were first developed in 1997. Eye trackers allow the laser to compensate for eye movements during the
surgery.
Custom Wavefront
treatments: Modern Custom Wavefront treatments started gaining popularity between 1998 and 2001.
They take higher order aberrations (HOA) into consideration and minimize the most common HOA, known as
“spherical aberration.” It is the spherical aberration that causes the appearance of halos around lights in
dim light conditions.
Thinner, safer
flap makers:Between 1997 and 2001, newer, gentler keratomes were designed to allow for the creation
of very thin LASIK flaps of 100 microns. This also made it possible to create flaps on corneas with fragile
surfaces.
Femtosecond
technology:Since
2001, femtosecond lasers have evolved as an alternative method of creating flaps.It still remains unclear
when it is preferable to choose a femtosecond laser over the newer generation microkeratomes.
Topoguided
treatments:This
fascinating development has allowed us to “fix” almost any problem due to an irregular corneal shape.
Canada has been an international leader in the development of these new technologies, contributing to the
adoption of LASIK as a procedure that provides excellent results and an outstanding record of safety. LASIK's
impressive results have helped make the procedure itself very popular in Canada. LASIK MD, Canada's largest
laser vision correction provider, performed over 60,000 procedures in 2010.
Over the past 20 years, LASIK technology has proven to be reliable, safe and effective. There has truly never
been a better time to have LASIK surgery. •
