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The Evolution and Development of Laser Eye Surgery

Thursday, March 27, 2014 @ 07:03 AM
Author: Amit Mathur

These days, if you experience issues with your vision, especially common ones such as refractive errors, you can quickly and easily get these corrected. These vision maladies include nearsightedness, astigmatism, and farsightedness. Once you visit with your ophthalmologist, you can receive a pair of eyeglasses or contacts to reverse the issue. Those who want to completely stop wearing any form of eyewear often turn towards laser eye surgery. While this treatment has remedied many an eye issue over the years, it only became a viable option in the 1990s.

Radial Keratotomy – The Early Days

The first steps made towards the laser eye surgery that you know today began back in 1898. That year, doctors developed the first form of the procedure called radial keratotomy, more commonly abbreviated as RK. Specifically, surgeons would use RK for patients suffering from nearsightedness. The procedure involved a surgeon cutting a few tiny openings around the patient’s cornea. The way that the surgeon would make these openings would allow the cornea, which had been raised, to smooth itself back out. Thus, the way that the retina sees light would also correct itself.

While this procedure sounded foolproof, it actually had several disadvantages. Doctors thought that it was a rather unstable procedure since the results weren’t always the same. Even when surgeons returned to RK in the 1960s, they still weren’t able to improve it to a point where it became the go-to option for patients with eye issues.

Automated Lamellar Keratoplasty Changes the Game

It wasn’t until the 1990s that a truly viable form of eye surgery came to light. Called automated lamellar keratoplasty or ALK, doctors had spent quite some time figuring out a better procedure in which to perform laser eye surgery. Patients considered ALK less invasive since it no longer involved as many incisions directly to the cornea. What it did entail involved a surgeon using a microkeratome, a type of cutting device, to slice the cornea once. Once again, the surgeon would then smooth the cornea. However, they would also take away some tissue in the area before resealing the incision.

The procedure completely changed the laser eye surgery game, as by the middle of the 1990s, ALK surgeons received permission to perform the procedure on a larger scale. ALK still lacked completely stable results. However, it had a much better track record than RK.

Photorefractive Keratectomy Continues the Advance in Methods

By 1995, surgeons developed photorefractive keractectomy, also known as PRK. This method truly defined itself as a laser eye surgery procedure given that it required no incisions at all. Up until this time, the Food and Drug Administration (FDA) had not allowed for surgeons to use excimer lasers in surgical procedures. It was only in 1995 that the FDA finally changed their minds and thus true laser eye surgery was born.

At that point, PRK could treat nearsightedness only by targeting the cornea. The laser would smooth this area out and improve vision. As the technology continued to evolve, PRK could also treat astigmatism and farsightedness. The only downside for the patients involved the very long recovery times after the procedure.

LASIK Goes Mainstream

By 1999, doctors found an even better laser eye surgery method than even PRK. Commonly called LASIK, laser assisted in-situ keratomileusis had actually existed as early as 1989 when Ioannis Pallikaris created it in Greece. It took a while for the procedure to migrate to the United States though, and even longer to receive the green light from the FDA.

Unlike PRK, LASIK does require a small incision in the cornea that thus allows the laser to work the most efficiently. These lasers would then smooth out the cornea. While this procedure seems like more of a hassle than even PRK, it has far more advantages. First of all, doctors had found the most predictable form of laser eye surgery yet. Also, due to the means in which surgeons performed LASIK, patients didn’t have to take nearly as long to recover. The process also was far less painful than getting over PRK surgery.

Visian ICL Presents another Viable Option for Vision Issues

In 2005, patients had yet another option at their disposal. Visian ICL or the phakic intraocular lenses have existed since 1992 where the Fyodorov Institute in Russia developed them. These lenses actually move alongside your eye’s natural lenses to improve vision. They only became available in the United States in 2005 since extensive testing was necessary to ensure the safety and effectiveness of the product. However, Visian ICL did pass these clinical trials and now anyone can use this vision option.
With this procedure, a surgeon makes a small cut to insert the lenses near your eye lens and cornea. However, the procedure doesn’t take long and patients tend to see better vision practically right after the surgery. You can keep the lenses in your eyes for as long as you like, and you can get them removed if you ever decide to. Of all the options, patients enjoy the speed and high rates of effectiveness of Visian ICL.

Laser Eye Surgery Today

As you can see, many different options exist today for a patient looking to undergo laser eye surgery. As the years have passed, doctors have improved LASIK and other procedures such as Visian ICL even more than when these procedures first existed. Therefore, you can feel assured that these surgeries are safer now than they’ve ever been. They treat eye issues effectively and permanently.

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