LASIK Surgery

More than 40 million LASIK procedures have been performed worldwide, and most people achieve 20/20 vision or better, with the vast majority seeing well enough to drive without glasses.

And to think it began with a bicycle fall and a laboratory accident. 

The fall happened to a boy in Russia. His glasses shattered, leaving shards of glass in both eyes. Dr. Svatoslav Fyodorov removed the glass. When he checked the healed eyes several months later, he found the boy's vision had improved. 

Fyodorov realized the cuts from the glass had flattened the child's cornea, the outside layer of the eye that bends and focuses light, improving his distance vision. After studying how radial cuts could reshape the cornea, Fyodorov developed a procedure to correct nearsightedness. 

Meanwhile, in Columbia, Jose Barraquer had developed a technique to modify the cornea. First, he shaved off the top of the cornea to create a flap. Opening the flap, Barraquer surgically reshaped the cornea to improve vision. After he flipped back the flap, the cornea healed quickly. 

Fyodorov's and Barraquer’s techniques often improved vision but they yielded uneven results. 

Then, in 1980, lasers entered the picture. IBM researchers were looking at new uses for excimer lasers. They discovered that instead of burning tissues like other lasers, excimers vaporized tissue by breaking chemical bonds. It happened so fast, it did not scorch surrounding tissue. By the end of the decade, doctors were sculpting corneas with lasers, which were far more precise than scalpels.

Yet manually sliced flaps continued to cause variability. This problem was solved when a graduate student at University of Michigan accidentally received a femtosecond (quadrillionth of a second) laser blast in his eye. It left a series of tiny burns on his retina without damaging surrounding tissues. Researchers realized they could use the same laser to vaporize hundreds of thousands of points just under the cornea. This created a layer of bubbles that allowed them to lift away a precisely formed flap. 

Today's LASIK systems use both femtosecond and excimer lasers. The result is one of the safest and most effective elective surgeries in the world.