History of methods of laser vision correction

Improvements of methods along with the introduction of new technologies allow helping patients with vision errors in most delicate and least invasive way. In the past, the only available solutions for people suffering from hyperopia or myopia were glasses and, invented later, contact lenses. Today, thanks to laser vision correction the beauty of world can be rediscovered.

In 1970 scientists of the University of Columbia invented excimer laser, and introduced it as a method of vision correction.

In 1985 first laser vision correction surgery using PRK method (Photorefractive keratectomy) was performed in Berlin. In 1991 excimer laser was confirmed as a tool for PRK surgeries in Canada, in 1995 – in the USA.
PRK method was initially developed to treat myopia by removal of a small part of the cornea. Latter technological development allowed surgeons to also treat patients suffering from hyperopia or astigmatism. The laser operates directly on the surface of the cornea after mechanical removal of the epithelium. Contact lenses serve as dressings in those types of surgeries. Recovery after PRK surgeries is pretty long and painful.

Meanwhile, in 1989 Italian ophthalmologist Burrato improves the PRK method and creates LASIK method (Laser-Assisted in situ Keratomileusis). In 1991 Greek ophthalmologist Pallikaris introduces many improvements to LASIK method. Operator uses microkeratome to create a flap on the surface of the cornea, the flap is, after the surgery, put back in place to create a natural dressing. This minimises the discomfort, allows fast recovery and almost instant return to everyday life. Since 1990 the LASIK method has become incredibly popular in Europe and America.

Year 1999 is when LASEK method (Laser Subepithalial Keratomileusis) was developed. Italian ophthalmologist Kamelin Massimo is considered to be the inventor of this method. LASEK is advanced version of PRK method, it is characterised by lesser pain and shorter recovery period. During the surgery an alcoholic solution is applied in order to soften the surface of the epithelium, which is put aside during laser operation. After the procedure, epithelium goes back in its place and soft contact lenses are applied as a form of dressing. This method is used when medical condition doesn’t allow for appliance of LASIK method.

In 2003 Greek professor Polikaris develops EPI-LASIK method. It is a method based on LASEK. Special tool called epikeratome mechanically separates the surface of the epithelium. Epithelial flap is created without using alcohol, which increases rate of survivability of the cells and shortens the recovery period. Discomfort and pain are lower than in PRK or LASEK methods. After the procedure, soft contact lenses that supplement healing process are applied.

Year 2003 also marks beginning of Intra-LASIK (or iLASIK)/Femto-LASIK method. This type of surgery involves 2 different lasers, first of which is femtolaser which creates a thin flap of the cornea. The second one is an excimer laser which corrects the vision error.

In 2009 SBK LASIK method was developed. It is a more delicate version of the LASIK procedure. SBK LASIK means painless and almost instant recovery. Majority of the patients enjoy fine and correct vision few hours after the procedure, they do not report any discomforts on the next day and are able to go back to their everyday routine (including driving). Photophobia is significantly weaker than after other procedures, risk of dry eye syndrome is also minimised. Rules of the recovery are very simple and drops need to be applied for about a month after the surgery. SBK LASIK is a chance for those with thin cornea and high refractive errors.

According to many specialists EBK method (2010) is mostly the same as PRK (1985) with a slight difference. In PRK the epithelium is removed with a metal tool. In EBK the epithelium is also completely removed with metal tool with plastic cap called epikeratome, which sucks the removed epithelium, leaving open wound on the surface of the cornea. Both methods are characterised by acute pain, slow recovery, high risk of corneal haze and scars.

Other variation of the PRK method is TransPRK. In this method the epithelium is removed with an excimer laser, that’s why the method is called ‘contactless’. Cornea is being shaped using the same laser and no other tools are used in this procedure, however an eyelid speculum is applied before the surgery. TransPRK is a method of laser vision correction which has been available for many years but it is very rare due to severe pain, long recovery period and possibility of corneal haze.

Laser vision correction is a great way of treating vision errors such as: hyperopia, myopia and astigmatism as well as the combinations of the above. Full predictability of the effects after the qualification, choosing best method for each patient along with the state of the art technology makes laser vision correction most efficient and highly safe way of correcting vision errors. Surgeries performed in ArtLife Ophthalmology Centre are modern alternative to traditional methods of correcting vision such as glasses or contact lenses. What is more they guarantee better sense of comfort, freedom and quality of life.

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