Eye Surgery Background And Advancements
Radial Keratotomy - The history of laser eye surgery goes back almost 100 years. Lans, a Dutch Ophthalmology professor, explained the basic principles of keratotomy in 1898. Sato, a doctor from Japan, did some pioneering trials with corneal incisions during the '30s. However, many of his patients suffered from late corneal decomposition after the treatment.
Radial keratotomy was put in practice by Dr. Fyodorov in Russia in 1970s, to treat a case of eye trauma. He used this technique to treat a boy who suffered from corneal lacerations after breaking his glasses. After treatment, the patient's vision was better than before injury. This success determined Fyodorov to make some research on past efforts in this field. His findings caught the attention of American ophthalmologists in 1978.
Dr. Leo Bores was the one to bring the technology to the United States after visiting Dr. Fyodorov in Russia. Since then, over 2 million people received radial keratotomy only in the United States. The discovery of certain limitations of radial keratotomy determined doctors to research alternative forms of eye surgery.
The Excimer Laser The use of the Excimer laser was another important step in the history of laser eye surgery. Dr. Srinivasin was the first to discover its potential in interacting with biological tissue while working in the IBM research labs. Dr. Steven Trokel was the one to use it for the first time in reshaping corneal tissue. This laser device emits a cold beam that when interacting with corneal tissue, destroys carbon-carbon bonds between molecules, causing tissue ablation. The excimer laser has been used in refractive surgery worldwide since 1987 and proved a high level of effectiveness and safety. Millions of patients suffering from various eye conditions have undergone this procedure. Photorefractive Keratectomy (PRK) Photorefractive keratectomy was also an important progress in the history of laser eye surgery. The first PRK surgery was held in 1988 in Germany. Millions of surgeries have been performed since then all over the world. Laser Assisted In-situ Keratomileusis (LASIK) LASIK is a more recent discovery in the history of laser eye surgery. The surgeon uses a blade to cut a flap of the cornea and then a laser to remove tissue underneath the flap. Compared to PRK, this procedure allows the cornea to remain mostly intact. Therefore, the patients who have LASIK feel more comfortable and recover better and faster after surgery. Surgeons have been performing LASIK for about 15 years now. The first surgery was performed in United States trials in 1991. However, the main components of this procedure have a much longer history. Ophthalmologists have been using different methods to reshape the cornea for over 50 years, creating protective layers for over 40 years and using an excimer laser since late '80s. In 1996, the FDA approved the laser treatment for myopia up to -6.00 diopters and in 1997; this procedure was approved for treating astigmatism up to -4.00 diopters. Recent progress in the history of laser eye surgery includes advanced procedures to overcome the risks associated with laser treatment. Current technologies such as IntraLense use an extra laser instead of a blade and provide better safety and faster recovery. Other techniques allow an advanced level of accuracy and predictability, increasing the chance for a successful procedure. Laser eye surgery is a medical procedure consisting of the use of laser for reshaping the surface of the cornea. It is used to improve myopia (shortsightedness), hypermetropia (long sightedness) or astigmatism. The first information on laser eye surgery dates back from over twenty years ago. During laser eye surgery, an excimer controlled by a computer is used to remove tiny amounts of corneal tissue. The aim of the procedure is to restore normal vision, relieving the patient from wearing glasses or contacts. In one type of laser eye surgery, the outer layer of the cornea, also called epithelium, is removed and an excimer laser is used to reshape underneath tissue. This procedure is called photorefractive keratectomy (PRK). In a newer procedure, a microkeratome is used to cut a flap in the corneal tissue, which is then lifted and an excimer laser is used to reshape underlying tissue. In the end, the flap is put back to its place. This type of laser eye surgery is called laser-assisted in situ keratomileusis (LASIK). Nowadays, it is more commonly used than PRK. Information on Laser Eye Surgery Procedure The excimer laser is a special type of laser that does not burn the corneal tissue, but vaporizes a small quantity of the cornea each time a beam is pulsed onto the eye surface. The number of pulses and diameter of the beam are carefully controlled by a computer to enhance accuracy. Local anesthetic eye drops are used before the surgery. The procedure takes a few minutes per eye. The actual time when the laser is used for reshaping the corneal tissue is generally less than a minute. Various eye conditions require different types of treatment:
l Myopia - the central peak of the cornea has to be flattened in order to reduce short-sightedness and improve vision.
l Hypermetropia - the central peak of the cornea has to be made steeper in order to improve vision. The laser is applied to the edges of the cornea.
l Astigmatism - this is a condition where the cornea is not evenly curved. The laser is applied more linear to improve vision.
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