Technological development

The LASIK technique was made possible by the Colombian-based Spanish ophthalmologist Jose Barraquer, who, around 1950 in his clinic in Bogota, Colombia, developed the first microkeratome, used to cut thin flaps in the cornea and alter its shape, in a procedure called keratomileusis. He also provided the knowledge about how much of the cornea had to be left unaltered to provide a stable long-term result.

In 1980, Rangaswamy Srinivasan working at IBM Research Lab discovered that an ultraviolet excimer laser could etch living tissue in a precise manner with no thermal damage to the surrounding area. He named the phenomenon Ablative Photodecomposition (APD). Srinivasan and his co-inventors ran tests using the excimer laser and a conventional, green laser to etch organic matter. They discovered that while the green laser produced rough incisions, damaged by charring from the heat, the excimer laser produced clean, neat incisions. In 1983, Srinivasan collaborated with an ophthalmic surgeon to develop APD to etch the cornea[1].

LASIK surgery was developed in 1990 by Lucio Buratto (Italy) and Ioannis Pallikaris (Greece) as a melding of two prior techniques, keratomileusis and photorefractive keratectomy. It quickly became popular because of its greater precision and lower frequency of complications in comparison with these former two techniques. Today, faster lasers, larger spot areas, bladeless flap incision, and wavefront-optimized and -guided techniques have significantly improved the reliability of the procedure as compared to that of 1991. Nonetheless, the fundamental limitations of excimer lasers and undesirable destruction of the eye's nerves have spawned research into many alternatives to "plain" LASIK, including all-femtosecond correction (Femtosecond Lenticule EXtraction, FLIVC), LASEK, Epi-LASIK, sub-Bowman’s Keratomileusis aka thin-flap LASIK, wavefront-guided PRK, and modern intraocular lenses.

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