Early experiments in Japan

The story of refractive surgery is long and not well documented. However, it is known that some early experiments were performed by Tsutomu Sato, a Japanese ophthalmologist, in the 1930s. He made the first attempts at making radial cuts in the cornea to improve vision for military pilots. Unfortunately, there was a high rate of corneal degeneration, so this could not be called a success.

An accident in Russia leads to a breakthrough

In the 1970’s, Dr Fyodorov in Russia was treating a boy who had accidentally broken his glasses, causing corneal lacerations.

To his surprise, as the boy recovered, he realized that the boy’s vision was significantly improved compared to his myopic condition before the accident.

This led Fyodorov to further research refractive surgery, producing a formula that allowed more accurate results than had been previously been attained.

From here, a technique known as radial keratotomy was born, and helped create a renewed interest in the field of refractive surgery. Radial keratotomy was taken up all across the globe, with over 2 million patients being operated on in the USA alone.

Next Stop – USA

Meanwhile during this time, experiments with laser for industrial purposes resulted in the invention of the Excimer laser, which was used to make microscopic circuits in microchips.

In fact, a team of IBM scientists (Rangaswamy Srinivasin, James Wynne and Samuel Blum) were the first to understand and demonstrate the potential of laser to cut organic tissue without causing significant heat damage. This discovery led to Dr Stephen Trokel patenting the use of the Excimer laser for vision correction in 1982.

The New York ophthalmologist went on to perform the very first laser surgery on a patient in 1987 and, from then on, the techniques using Excimer laser were refined and improved extensively.

The LASIK revolution

While the early laser technique, known as photorefractive keratectomy (or PRK) proved to be very successful, it was the appearance of LASIK, first trialed in 1991, that really moved the game on.

LASIK (laser assisted in-situ keratomileusis) proved to be less invasive, leaving the surface of the cornea largely intact, so allowing patients a more comfortable and faster recovery.

 Enter Wavefront-guided LASIK

Waverfront-guided LASIK is a more developed procedure, which applies a spatially varying correction, guiding the computer-controlled Excimer laser with measurements from a wavefront sensor.

It’s essentially a refinement of LASIK and has proved highly successful, achieving a 95.4% patient satisfaction rate amongst patients over a 10 year period. Further support for Wavefront-guided LASIK has come from the US Air Force, who have given the procedure their approval for the vision correction of pilots, finding that Wavefront-guided LASIK produced ‘superior vision results’.

The future?

While laser eye correction has successfully improved the vision and lives of literally millions of people the world over, we can rest assured that development continues and even more successful technologies will no doubt appear in the future.