Laser Eye Surgery Massachusetts
The History of Laser Procedures
The LASIK-procedures were first adopted by a Spanish ophthalmologist Jose Barraquer in Colombia. In 1950 he invented the very first microkeratome in his clinic in Bogotá, which was intended to cut a thin flap in the cornea and in doing so, alter the shape of the cornea.Barraquer was also the first to study, how much and how should the cornea be altered to raise visual acuity to provide stable and long-term results.
His procedures were called keratomileusis.The technology was later enhanced by Svjatoslav Fjodorov in the 1970s in Russia, who invented the RK-method (radial keratotomy) to correct the eyes. During the RK-procedure a diamond knife is used to make 4-6 incisions 2 mm in depth, which extended from the colored to the area line of the white part of the eye, and right after the operation a person starts to see. This procedure had nothing to do with lasers.
What is PRK?
Laser was put to play in the 1980s when a German Theo Seiler worked out the PRK-method (photorefractive keratectomy; later LASEK-method). The first operation based on the PRK-method was performed at Massachusetts Eye and Ear Infirmary in 1996 by Dr. Dimitri Azar. The term LASEK (laser epithelial keratomileusis) was worded by Massimo Camellin.
LASEK and PRK-procedures permanently alter the shape of the cornea using an excimer laser.In the course of both procedures the anterior layer of the cornea, aka the re-growing layer, is removed and the laser ablates the surface of the corneal stroma so that nearsightedness is reduced.In the case of the PRK-method the anterior layer is left to re-grow itself, during the LASEK-method the cut out layer of epithelia is kept in a special solution before it is placed back on the eye after the procedure.
A computer is used to track the eye’s movement 60 to 4 000 times per second (depending on the brand of laser) to direct all the laser pulses into the right spot. Most modern lasers track also the eye’s visual axis and pause, if the eye moves too much.The anterior layer of the cornea, aka epithelia, is a soft, rapidly re-growing layer of cells, which is constantly in contact with the tear film and is able to regenerate itself within a couple of days without losing its clarity.The deeper layers of the cornea are formed in the mother’s womb and their regenerative abilities are extremely limited.
If the deeper layers of the cornea are ablated with the laser or cut with the microkerotome, their former shape doesn’t return and it stays exactly like the laser shaped it.This makes refractive surgery possible: the breaking of the light in the cornea is changed and figuratively speaking an additional lens is shaped within the cornea that helps the person to see clearly.The vision changes a little after the operation, because every person’s cornea has different healing abilities, but the visual acuity achieved during the operation remains mostly the same.
What is LASIK?
In 1968 a group of scientists led by Mani Lal Bhaumik invented the excimer laser, while working on the development of a carbon-dioxide laser. This was the cornerstone for Laser Eye Surgery. Dr. Bhaumik announced his discovery in May 1973 at a conference of the Optical Society of America in Denver, Colorado and later patented it.The next step in the development of the modern LASIK-operation was made in 1980 by Rangaswamy Srinivasan, who, while working at IBM Research Lab, discovered that an ultraviolet excimer laser could cauterize living tissue in a precise manner without thermal damages to the surrounding tissue.
He named this phenomenon Ablative Photodecomposition; APD. In 1983 Dr Stephen Trokel published an article in the American Journal of Ophthalmology, where he emphasized the possibilities of using excimer laser in refractive surgery. The first patent for LASIK-procedure was granted by the US Patent Office to Gholam A. Peyman on June 20, 1989. It described the surgical procedure called laser-assisted in situ keratomileusis, during which a flap was cut in the cornea and pulled back to reveal the corneal bed underneath.
The exposed surface was then ablated with the excimer laser in order to achieve the desired shape, following which the flap was adjusted back to its former place.The main Difference Between Lasik And Prk lies in the method, how the middle layer of cornea, or stroma, is reached. In case of PRK the flap (like with LASIK) is not cut, but the anterior layer, aka epithelia, is scraped off to get to the stroma. The development continuesWhile continuing the research that began in the 1950s, Lucio Buratto (Italy) and Ionnis Pallikaris (Greece) invented the modern laser procedure in 1990, as they combined two prior procedures – keratomileusis and photorefractive keratectomy.It quickly became popular because it was more precise than the former procedures and had a noticeably lower frequency of complications.
LASIK-procedures are used to correct myopia, hyperopia and astigmatism and it is preferred over PRK, because the procedure is less painful for the patient and the recovery time is shorter.Today lasers are becoming faster, the treatable area broadens, during the operation it is possible to measure the thickness of the cornea, you don’t have to use blade for the cutting of the flap (Femtosecond-lasers) and Wafefront-technologies have significantly improved the reliability of the procedure compared to earlier days.
Despite all, the research is not slowed down, but new and better solutions are invented in reflective surgery: e.g. vision correction with only Femtosecond-method, Epi-Lasik, so called thin-Flap Lasik, Wavefront-PRK and modern intraocular lenses. We hope to talk about all of these soon on the KSA webpage as well.
About the Author
Ants Haavel has performed more than 5500 refractive surgeries. Visit KSA Silma Laseroperatsioonid for more info.
LASIK in BOSTON with Dr. Marc Leibole
May 10th, 2010 at 10:19 am
mabey you should just continue with contacts. Then you can wear glasses when you want and contacts when you want. you can use glasses as a accessory
June 2nd, 2010 at 3:48 am
Hi, Yes I had it done and it has worked brilliantly, I can recommend Optical Express, they were fab, so professional, I have had the basic surgery done and my eyesight is now 6/5 vision or 20/10 in the USA. It is the best thing I have ever done, it does not hurt and it is not even uncomfortable.