Laser eye surgery has proved to be one of the most effective and remarkable inventions of the 21st century – coming to the aid of thousands of people affected by poor eyesight.
What is Refractive Surgery?
Refractive surgery (which includes LASIK eye surgery) is a method where the refractive property of the eyes is improved, which diminishes the individual’s dependence on glasses and contact lenses.
A laser is a focused and intense beam of light. Its mechanism depends on the kind of laser used and the type of eye tissue being treated. Refractive surgery can correct common vision disorders such as myopia, hyperopia, astigmatism and even the keratoconus – which is a congenital, progressive, and severe disease of the cornea.
Here is a timeline of important milestones in the field of laser vision correction:
Read the detailed version below:
The first data from 1896 can be traced back to the Netherlands. Jans Lans, M.D published a theoretical paper on the possibility of cuts made in the cornea to rectify corneal curvature and cure astigmatism.
And that was the impulse that led to the accelerated development of laser eye surgery: in 1960 Keratomileusis was already known about, and in 1970 this technique was revolutionized with the excimer laser which created a path for all further discoveries.
The excimer laser was primarily used industrially, but things changed thanks to the efforts of three researchers from the IBM.
During 1973-1983, excimer laser was first used on organic tissues with high precision and minimal thermal damage.
An excimer laser is an ultraviolet laser that can break down molecular bonds of corneal tissues. This is done by converting them into vapor them in a cold manner (to avoid scarring), at supersonic speeds. This takes lesser time, and only requires a topical anesthetic in the form of eye drops.
Dr. Steven Trokel introduced Photorefractive Keratectomy in 1980 and performed the first laser surgery on a patient’s eyes in 1987. In 1995 PRK was approved by the FDA.
It was the first kind of corrective eye surgery to use a laser rather than a blade to remove corneal tissue. Intended to only treat myopia, further refinements made it suitable for hyperopia and astigmatism treatment.
In PRK, computer-controlled pulses are directed at the exposed surface to reshape the cornea. Because of this, recovery is lengthy and uncomfortable, but the deeper layers of the cornea remain untouched. This plays an important role in the long-term evaluation of patients who undergo PRK, with less incidence of dry-eye disease.
The idea of combining previously-proven flap technology and reshaping the cornea with the excimer laser occurred in the early 1990s and the dawn of LASIK surgery began.
The LASIK process also uses the excimer laser to reshape the cornea, but it is done under a thin, protective, corneal flap.
An advantage of refractive vision correction performed in the interior of the cornea (LASIK) over refractive vision correction performed on the cornea’s surface (PRK) is:
- Faster Recovery – Rather than vaporizing the epithelial cells to expose the corneal stroma, a specialized instrument known as a microkeratome creates a flap of corneal tissue. The flap is held in position by the eye’s natural suction facility, providing increased comfort and decreased recovery time for the patient.
Epipolis-laser in situ keratomileusis (epi-LASIK) was first reported by the Greek doctor Pallikaris in 2003. Compared to LASIK, the epi-LASIK comes with certain improvements.
During a LASIK procedure (also called the flap-and-zap method), a cut is made across the cornea – for creating a flap. This flap is then lifted, after which the underlying cornea tissue is subjected to laser correction.
In epi-LASIK, however, no flap is created on the eye. This can be an advantage for you if you have thinner-than-normal corneas. During this procedure, the uppermost surface layer of cells (the epithelium layer) is removed via surface ablation, where approximately 30 microns of the epithelium is moved aside, after which the underlying cornea is treated with laser. As the epithelium cells have regenerative properties, they will grow back within 3-5 days, thus preventing corneal tissue loss and nerve damage.
After the surgery, as your epithelium layer is exposed, the surgeon typically applies a soft contact lens over your exposed cornea. The contact lens acts as a bandage to increase comfort and allow new epithelial cells to grow onto the cornea more quickly for faster healing.
Your surgeon or eye doctor will remove the bandage contact lens at one of your early follow-up visits a few days after your epi-LASIK procedure.
Epi-Lasik is safer than LASIK if you have certain hobbies such as contact sports or are a person with active lifestyle, you do not have to worry about the risk of flap dislodgement during your activities.
SMILE, passing the Conformite Europeenne (CE) certification in 2009, is a technique to correct certain refractive errors, namely nearsightedness and astigmatism.
ReLEx (Refractive Lenticule Extraction) SMILE (Small Incision Lenticule Extraction) is a vision correction procedure that uses only one laser (the femtosecond laser). Rather than vaporizing the cornea tissue to correct myopia and astigmatism, ReLEx SMILE removes a small piece of corneal tissue (lenticule) via a tiny keyhole incision (2-4 mm).
Safe Sight Transepithelial photorefractive keratectomy (TransPRK), is an all-laser one step no touch procedure where both the epithelium and stroma are removed in a single step, using only the excimer laser.
The advantages of choosing Safe Sight TransPRK Epi-Lasik are:
1. Suitable for More Eyes – Patients who are rejected from LASIK might be able to go for SafeSight TransPRK. This is because SafeSight TransPRK requires less cornea thickness compared to LASIK.
2. For High Myopia – SafeSight TransPRK is also suitable for patients with high degree, as the procedure can correct up to 1200 degrees.
3. Safe – No cut or no flap involved in the surgery.
4. Speed – It only takes around 15 to 20 seconds of laser time per eye.
As you can observe from our timeline, laser vision correction has shown drastic improvements over the years. If you’re considering LASIK surgery, you can pick from safer LASIK eye surgery options for your specific needs today.
Laser vision correction today might possibly be the leading option to have a free and comfortable life without glasses or contact lenses. Many have opted for laser vision correction to take the easier way of life and live with fully-corrected vision. Thanks to advanced technology, laser vision correction today is relatively fast, pain free and accurate. However, even though they’re rare, there are potential risks of under or over correction in laser.
Given these reasons, you would need to choose the right surgeon for yourself – someone who has a time-tested record in the field of laser eye surgery, and will be capable of gifting you your eyes without the glasses.
Get in touch with us today to experience the benefits of laser vision correction!