Looking Back: The History of Laser Vision CorrectionAuthor: Dr. William Tullo
July 11, 2013
Laser vision correction has a long history. Humans have long looked for ways to correct vision. The first eye glasses appeared in 13th-century Italy, and the first contact lenses (made from hand-blown glass) showed up in 1888 Switzerland. But even as these innovations advanced, doctors around the world sought a permanent solution to common vision problems.
In the 1970s, one invention propelled doctors toward that solution: the excimer laser. This new technology caught the eye of Columbia University researcher Stephen L. Trokel, who borrowed one and used it to perform laser vision correction. He started by worked on animal cadavers, then human cadavers, and eventually living rabbit and monkey corneas.
First human laser vision correction
In 1988, a 60-year-old woman diagnosed with malignant melanoma, which left a growing black spot on her eye, asked scientists if they would like to perform an experiment on her eye before it was removed.. Trokel’s colleague, Marguerite McDonald, performed the first photorefractive keratectomy, or PRK, procedure on the woman that year. In 1991, Canada approved the excimer laser for use in PRK, and in 1995 it was approved in the United States.
Meanwhile in 1990, two European eye doctors enhanced PRK by developing what would become LASIK. Greek eye doctor Ioannis Pillakaris and Italian eye doctor Lucio Burrato developed two types of what was then loosely known as “flap and zap”. Instead of working on top of the corneal surface, Pillakaris and Burrato used a blade to cut a thin flap in the cornea, zap the tissue underneath, and replace the flap like a natural bandage. The flap allowed for less discomfort and a faster recovery. This procedure, now known as LASIK, was approved in the United States in 1999.
Refining laser vision correction
Doctors continued their efforts to make laser vision correction even better. In 1999, scientists developed wavefront analysis. Wavefront technology maps a patient’s prescription. These corneal maps are as unique as fingerprints.
By programming wavefront analysis data into an excimer laser, the laser could more precisely reshape a patient’s cornea, resulting in a truly customized procedure with improved results. Wavefront analysis for LASIK gained U.S. FDA approval in 2002—the same year LASIK became the world’s most common elective procedure.
That year saw another invention: 100% bladeless laser eye surgery. With bladeless LASIK, a a femtosecond laser, not a blade, is used to create a corneal flap at the precise depth and diameter desired by the surgeon. Both bladed and bladeless LASIK are proven safe and effective, but bladeless LASIK offers a variety of important advantages for many patients.
My, how far vision correction technology has come since eye glasses first appeared in 13th century Italy.