A brief history of surgical vision correction: when it all started and what the most advanced correction methods are available today

The history of surgical vision correction dates back to the 1950s, when Japanese ophthalmologist Dr. Sato performed a series of procedures on volunteers with myopia. Initially, he made corneal incisions using a traditional scalpel. Although the improvement in patients’ vision was significant, these procedures were fraught with a high number of postoperative complications. Dr. Sato stopped performing this type of procedure, this around 1973, but specialists were still looking for new solutions.

Russian ophthalmologist, Vyataslow Fyodorov, based on his own experiments (first on animals, then on humans), somewhat modernized Sato’s technology and initiated the procedures known today as RK(Radial Keratotomy). The techniques used by Fyodorov – HK(Hexagonal Keratotomy), APK(Axis Parallel Keratotomy), AK(Axis Keratotomy), TK(Trasversal Keratotomy) – differed primarily in the method of incisions.

Another name worth remembering is Jose Ignacio Barraquer. In the literature, his surgical technique is most often referred to as LK(Lamellar Keratomileusis). Barraquer used a special device he invented called a microkeratome.

One of the older methods of refractive laser surgery is considered to be PRK (or photorefractive keratectomy). It is a surgical procedure that has been performed since the late ’80s.

The first successful excimer laser procedure was performed by Dr. Theo Seiler in 1987 (1 blind eye 1985, sighted 1987). And what happened later…?

• In 1991, the excimer laser was approved in Canada for PRK procedures
• In 1989, Italian ophthalmologist Buratto (or Pallikaris), working on the PRK method, improves it, resulting in the LASIK (Laser-Assisted in situ Keratomileusis) method.
• In 1995, the U.S. Food and Drugs Administration (FDA) approved the excimer laser and approved PRK, or photorefractive keratectomy, as a generally available medical procedure.
• In 1999, the LASEK (Laser Subepithalial Keratomileusis) method is created. Italian ophthalmologist Kamelin Massimo is considered the creator. LASEK is an advanced PRK that reduces post-correction pain and shortens the recovery period.
• In 2003, Greek professor Joannis Pallikaris develops the EPI-LASIK method. This year also sees the advent of Femto-LASIK – the procedure is guided by two lasers: a femtosecond laser, which separates the thin corneal flap, and an excimer laser, which removes the visual defect.
• In 2009, the SBK LASIK method (a milder variation of the LASIK method) is created.
• Relex smile probably around 2012 is released to the market

Twenty years after the excimer laser was listed by the FDA (that is, in 2015), it was decided to conduct a survey of ophthalmologists practicing refractive surgery in the US. The survey revealed m. in. that ophthalmologists are as much as 4 times more likely to undergo laser vision correction procedures and as many as 2/3 of them recommend these procedures to their immediate family members.

And what does laser vision correction look like today – in 2020?

Today we already know that there is no single objectively best method of laser vision correction. Laser treatments are tailor-made treatments – the most individualized ophthalmic procedures.

Any laser surgery is preceded by very detailed examinations. Although patients can read information on the web about the fact that a particular method is dedicated to people with such and such a visual defect, and among the contraindications are listed… – you should never skip the preliminary examinations.

Only an experienced refractive surgeon can assess whether we qualify for laser surgery.

If our cornea is too thin and the doctor will not be able to develop the so-called architecture of the procedure, i.e. plan the operation in such a way as to achieve the optimal result for the patient, and it will be impossible to program and carry out the procedure, even with the most precise lasers, the doctor will show us alternative methods of correction.

People who qualify for the procedures – we already know that laser vision correction is carried out by various methods, which are constantly developing and being improved – are myopic, hyperopic and astigmatic, as well as those suffering from so-called presbyopia (presbyopia). The latest surgical technologies make it possible to combine myopia/farsightedness/dystopia surgery with simultaneous removal of other vision defects, such as astigmatism.

Among the most advanced methods of laser vision correction are the following numerous surface and deep methods.

Laser correction of (defective) vision is now not only the best alternative to traditional glasses and contact lenses, but also the safest way of surgical intervention in the eyeball.

This is significant: laser vision correction is considered the most advanced method a refractive surgeon can reach for, but within this method, too, we can identify less and more advanced surgical techniques.

For the patient, this sends a clear message: laser vision correction is not an invention so fresh and unproven as to be feared. It is not a newfangled technical innovation. It is a range of methods and techniques whose safety and effectiveness have been verified over the years.

It is worth being aware that the SwissLaser clinic is a reference center of the company SCHWIND eye-tech-solutions.

The Reference Center is a place where doctors examine, diagnose and treat patients, and at the same time it has the character of a scientific institution: it allows the exchange of experience between specialists and the sharing of unique experiences in the medical field. So if somewhere patients can benefit from the most advanced methods of laser vision correction, it is here.