That's what I'm worried about... Irina's eyeballs exploding in 25 years and me having to lead her around by the hand
HISTORY OF LASER EYE SURGERY
There has been an interest in refractive surgery for almost 100 years. Lans, a Dutch professor of Ophthalmology, laid out the basic principles of radial keratotomy as early as 1898. In Japan, in the 1930's, Sato did some pioneering work with corneal incisions. He placed incisions in the endothelial surface of the cornea as well as the epithelial surface, but this technique resulted in late corneal decompensation for many of his patients.
It took the observations of Dr. Fyodorov of Russia, in a case of eye trauma in the 1970's, to bring about the practical application of refractive surgery through radial keratotomy.
Fyodorov was treating a boy whose glasses had broken, causing corneal lacerations.
Following recovery, this patient's refraction was significantly less myopic than prior to the injury. This discovery prompted Fyodorov to research past efforts in refractive surgery. He then worked out a formula which made this procedure more predictable than it had ever been before. In 1978, American ophthalmologists became interested in these findings.
Dr. Leo Bores was the first to bring the technology back to the United States after visiting Fyodorov in the Soviet Union. Since it was introduced, radial keratotomy has been performed on over 2 million patients in the United States alone.
Some limitations of radial keratotomy prompted research into alternate forms of refractive surgery.
Working in the IBM research laboratories, Dr. Srinivasin saw the potential of the Excimer laser in interacting with biological tissue. Dr. Steven Trokel, an ophthalmologist, finally made that connection to the cornea. This laser machine emits a non-thermal, cold beam, that upon interaction with corneal tissue, breaks the carbon-carbon bonds between molecules thus causing tissue ablation.
The excimer laser has an international track record for safety and effectiveness since 1987. Over two million procedures have been done. It is projected that in the year 2000, over one million will be treated in the U.S. alone.
The first patient to have photorefractive keratectomy was treated in Germany in 1988. As of November 1994, it is estimated that over 1,000,000 PRK cases have been performed in 40 countries around the world, with the number of cases rising exponentially - especially in Europe and East Asia. With new refractive technologies being actively developed, many feel confident in the fact that refractive surgery is here to stay.
At present, refractive surgery is most effective for myopia, astigmatism and hyperopia.
LASIK is the most recent advance in laser vision correction. LASIK is an acronym for Laser Assisted In-situ Keratomileusis. Compared to the original laser PRK, the surface of the cornea remains largely intact so that LASIK patients are more comfortable and see better more quickly.
LASIK has been performed internationally for approximately 10 years. It was first performed in U.S. clinical trials in 1991. It is important to note that the major components of the procedure have a long history. Ophthalmologists have been reshaping the cornea for over 50 years, creating a protective layer of tissue for over 35 years, and using the excimer laser since the 1980s.
In 1996, the FDA acted on the data submitted and approved the laser for treatment of low myopia up to -6.00 diopters. In 1997, the FDA approved the laser for treatment of astigmatism up to -4.00 diopters. There are currently three major manufacturers of the excimer laser equipment: Summit Technology, Visx and Nidek.
