Go Back in Time
You’re considering having refractive surgery. You’re hoping to improve your vision and get rid of your glasses or contacts. At first, you were just thinking about your own eyes, which procedure(s) you’d choose to have, and how you would pay for it. But as you dig in, you might get interested in how refractive surgery got started and how it’s changed over time. Why not take a few minutes to learn a little history? You might teach your friends something — and maybe even your surgeon!
How Refractive Surgery Got Started
Because modern LASIK relies on super-precise computer-guided lasers to achieve its feats, you might reasonably believe that it’s only a few years old. And while the current tools of the trade are indeed only a little over a decade old, LASIK itself started back in the 1980s.
Nope, LASIK Wasn’t First
Because LASIK is the laser corneal procedure that most people have heard of, it’s natural to assume that it was the first. But actually, the first refractive surgery was a PRK (photorefractive keratotomy) procedure. It was first performed on a live human eye in 1988 (after testing on donated cadaver eyes, of course). It was another year before the LASIK technology was patented in 1989, and another year after that before the first LASIK surgery was performed. It took until 1999 for LASIK to win approval from the FDA, but once that important step was achieved, LASIK took off. It quickly became the procedure of choice for many refractive surgeons, and for patients too.
LASIK, however, wasn’t perfect. The creation of the corneal flap was difficult using a microkeratome (a sharp surgical instrument that was used in early LASIK surgeries). Patients began to have concerns about flap complications. Many people didn’t want to take the risk of the LASIK-created flap dislodging, so they sought procedures like PRK and LASEK that don’t create flaps.
An advance in laser technology changed the playing field: the development of the femtosecond laser. This extremely precise instrument is able to make accurate cuts at precise depths, leading to the ability to create better LASIK flaps. Suddenly, LASIK seemed like an attractive option again to many patients. LASIK is currently the most popular refractive surgical procedure, well ahead of surface ablation procedures like PRK and LASEK. Thank the engineers!
Customize Your Eyes
Another limitation of early refractive surgeries, which applied to LASIK as well as to other laser corneal procedures, was the difficulty in creating precisely the corneal shape the patient needed. Because every eye is a little different, using standard settings for particular prescriptions don’t always work well. Halos, glare, and other visual symptoms that may occur after refractive surgery result from corrections that aren’t quite exactly right for the patient’s eye, and create minor corneal aberrations that distort vision.
The development of wavefront technology has made headway in this arena. Using a sophisticated measuring device called an aberrometer, and computerized topography of the cornea itself, eye surgeons now have a better ability to customize the laser ablation for each person, helping to reduce the risk of visual symptoms after surgery. Companies are now working on other so-called “optimization” methods, which may help laser refractive surgery become even better in the future.
Today, You Have Many Options
Doctors have spent many years developing refractive surgery, using newer and better techniques and materials. Today, you have a variety of options to help you improve your vision. So if you’re frustrated by your glasses or contacts, there’s reason for hope! Refractive surgery could free you from the hassle and give you improved vision through your own unaided (well, slightly aided, by lasers) eye.