New York Laser Vision Correction
History of Laser Eye Surgery
by Allan Robbins, MD
Millions
of years ago, cavemen with poor vision were a
delicacy for the T. Rex crowd, and the nearsighted
population was never much of a factor in society.
Today, it is estimated that over 50 million Americans
suffer from nearsightedness, and the number is
growing. These demographics combined with dramatic
advances in technology have catalyzed the explosion
of laser vision correction. We are bombarded by
the advertising in our homes, cars and even at
the movie theatres. Many of us wonder "What is
laser vision correction, where did it come from
and is it something we should be considering?"
The
tale of laser vision correction began in 1981,
when an IBM scientist discovered the first ultraviolet
"cold" laser by exciting Argon and Fluoride gas.
The beam emitted was called an excimer, a contraction
for "excited dimer", and the first applications
were for etching microchips. In 1983, the first
medical paper describing the reshaping the outer
clear lens (cornea) with this wavelength was published,
and laser vision correction was born. Research
on the excimer laser continued around the world
at a feverish pitch, and an international battle
for patent rights continues to this very day.
In the United States, clinical trials for the
treatment of myopia began in 1988 for Summit Technology
and 1989 for VisX. Rochester was fortunate to
be selected as one of the ten clinical sites for
VisX, and we now over 10 years of follow-up data
on many of our patients.
Prior
to 1988, the only surgical option for individuals
with myopia (inability to see clearly in the distance
without optical aids) was to undergo the operation
called RK or Radial Keratotomy. RK was "invented"
by Dr. Fyodorov of Moscow and imported into the
United States in 1979. The operation enjoyed some
popularity here in the late eighties as the notion
of performing surgery on healthy eyes gained acceptance
from ophthalmologists and the public. The incisions
were initially created with steel blades which
in the U.S. were replaced with precision diamond
micrometer knives. RK worked by effectively weakening
the outer portions of the cornea with a resultant
central flattening. Outcomes in skilled hands
were good, but astigmatism could not be corrected
well, nor could farsightedness.
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