The History and Evolution of Lasik

Lasik surgery originated in Colombia. There in 1970, Dr Jose Barraquer developed the first microkeratome - an instrument used to cut a thin flap of the corneal tissue. This procedure, known as keratomileusis, was pioneered and developed in Colombo's Barraquer Clinic.

The complete Lasik procedure was first carried out by Dr. Lucio Buratto (from Italy) and Dr. Ioannis Pallikaris (from Greece) in 1990. They combined two previously used techniques - keratomileusis and photo refractive keratectomy.  In 1991, Dr. Stephen Brint and Dr. Stephen Slade performed Lasik in the United States. In the same year, Dr. Thomas Neuhann and Dr. Tobias Neuhann performed it on German patients using an automated microkeratome. Lasik soon became a widely-used procedure. Its popularity was due to the low frequency of complications compared to old techniques.

Lasik is continually evolving with new technology making the procedure simpler and safer. One major innovation is that surgeons now use an Intralase device instead of a microkeratome. Intralase is a new technology which enhances the safety of Lasik. It uses infrared laser energy (a special laser) instead of a microkeratome (the cutting tool with a metal blade) to cut a flap from the cornea. Intralase technology uses two types of lasers - the one which cuts the flap and the other which smoothen the irregularities in the corneal tissue to obtain the desired focus of light inside the eye and on the retina, and ultimately corrects the vision. That is why it is promoted as “bladeless” and “all laser” Lasik.

Intralase Lasik is considered to be a breakthrough because it minimizes the rare but possible complications caused by the microkeratome. These include the possible creation of uneven flap edges resulting in abnormal corneal surfaces and vision defects (e.g. irregular astigmatism). This metal blade also may result in an incomplete or improperly formed buttonhole flap. This can cause vision threatening scars. However these complications happen very rarely.

Intralase is not without possible complications of its own. The Intralase laser operates at a very high speed (pulses of one quadrillionth of a second), so it does its job without heating the surrounding tissue. However, some eye surgeons recently reported a postoperative complication - an unusual light sensitivity. One surgeon reported 20% of patients experienced this complication. However, this complication is temporary and can be resolved with steroidal treatment with eye drops for a few weeks. So unlike the serious and permanent vision threatening complications resulted from defective flaps caused by a microkeratome, it is not a major problem.

Intralase procedure costs about $300 per eye more than standard Lasik. In most cases the patient is given the choice of having Intralase or the traditional Lasik, though many surgeons use only Intralase.