Lasik Eye Surgery

in Review

Lasik is the acronym used to describe Laser in Situ Keratomileusis.  It is a special type of refractive laser eye surgery that can only be performed by ophthalmologists.  The laser eye surgery is intended to help correct poor vision.

Development

Dr. Jose Barraquer created a procedure that was the first step toward the development of Lasik in 1970.  At this time, he created a microkeratome, which was used to change the shape of the cornea and to cut the thin corneal flaps.  This procedure was called keratomileusis.

In 1990, Dr. Lucio Buratto of Italy and Dr. Ioannis Pallikaris of Greece developed Lasik surgery as it is known today.  This was accomplished by combining Dr. Barraquer’s technique with photorefractive keratectomy, or PRK.  PRK is a form of laser eye surgery that permanently changes the shape of the anterior central cornea by burning off a small amount of eye tissue from the corneal stroma.  Today, this procedure alone is not preferred because it takes longer for patients to recover from surgery and is more painful than Lasik.

The combination approach, however, was shown to have a lower number of complications and to be more precise in correcting vision.  Dr. Stephen Slade and Dr. Stephen Brint first performed the procedure in the United States in 1991.  That same year, German doctors Thomas Neuhann and Tobias Nuehann completed the first automated Lasik surgery in Munich.

Pre-Surgery

Before beginning Lasik surgery, the surface of the corneas must first be examined using a computer controlled scanning device.  This serves to determine the exact shape of the cornea.  Low power lasers are then used to create a topographic map of the surface of the cornea.  This allows the surgeon to also determine the degree of astigmatism, if any, as well as other irregularities that might be present in the cornea’s shape. 

This information helps the surgeon determine how much corneal tissue needs to be removed, and from where.  Generally, the patient is also prescribed antibiotics beforehand.  This helps to minimize the risk of developing an infection after the procedure is completed.

In addition, Lasik patients who wear contact lenses are encouraged to stop wearing the contacts for days, or even weeks, prior to the surgery.  This is because the cornea needs to absorb oxygen in order to fully function.  Low-oxygen permeable contact lenses reduce the ability of the cornea to absorb oxygen.  This can result in blood vessels growing into the cornea in a process called corneal neovascularization.  This condition can cause an increase in the inflammation of the area and lead to a longer healing time.  It can also cause additional discomfort during surgery.