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Ocular System

Laser in-situ keratomileusis (LASIK)

Laser refractive surgery for the correction of myopia, hyperopia, and astigmatism

Introduction

Laser refractive surgery for the correction of myopia, hyperopia, and astigmatism

History:

In the 1950s, the microkeratome and keratomileusis technique were developed in Bogotá, Colombia, by the Spanish ophthalmologist Jose Barraquer. In his clinic, he would cut thin (one hundredth of a mm thick) flaps in the cornea to alter its shape. Barraquer also investigated how much of the cornea had to be left unaltered in order to provide stable long-term results. This work was followed by that of the Russian scientist, Svyatoslav Fyodorov, who developed radial keratotomy (RK) in the 1970s and designed the first posterior chamber implantable contact lenses (phakic intraocular lens) in the 1980s.

In 1980, Rangaswamy Srinivasan, at the IBM Research laboratory, discovered that an ultraviolet excimer laser could etch living tissue, with precision and with no thermal damage to the surrounding area. He named the phenomenon “ablative photo-decomposition” (APD). Five years later, in 1985, Steven Trokel at the Edward S. Harkness Eye Institute, Columbia University in New York City, published his work using the excimer laser in radial keratotomy. Together with his colleagues, Charles Munnerlyn and Terry Clapham, Trokel founded VISX USA inc. Marguerite B. MacDonald MD performed the first human VISX refractive laser eye surgery in 1989.

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