Laser therapies for use in medical treatments such as vision correction have existed since the 1980s.
The technique for what we now call refractive surgery had its origins in the work of Dr. Lendeer Jans Lans who theorised that cuts made in the cornea could rectify corneal curvature and cure astigmatism. He went on to publish a theoretical paper in 1896. Building on this theory Dr Jose Barraquer as far back as the late 1930s proposed that refractive errors such as myopia and hypermetropia could be corrected by modifying the shape of the cornea.
Our laser eye and cataract surgeon Mr Romesh Angunawela providing information on who invented laser eye surgery.
Around the same time, a Japanese Ophthalmologist Tsutomu Tsato first practised refractive surgery on war pilots making incisions to the cornea radially which improved their vision but later resulted in corneal degradation. Barraquer continued developing the stromal sculpting method at his clinic in Bogota during the 1960s which evolved into modern-day Lasik.
Dr Svyyatoslav Fyodorov, a Russian ophthalmologist went on to develop radial keratotomy in the 1970s, an eye surgery procedure which was designed to flatten the cornea by making cuts which followed a radial pattern. The event that led to this procedure being developed came about when a patient he had been seeing for correction of myopia caused by astigmatism, had an accident during which glass particles became lodged in both his eyes. To save the boy’s vision, Dr Fyodorov performed an operation which consisted of making numerous radial incisions extending from the pupil to the periphery of the cornea in a pattern like the spokes of a wheel. After the cornea healed he found that the boy’s visual acuity had improved significantly.
RK enjoyed great popularity during the 1980s and was one of the most studied refractive surgical procedures. But developments in the field of lasers propelled vision correction into a new arena. Light from a laser is tuned to specific wavelengths which allow the light to be focussed into powerful beams. These beams are so intense that they are able to precisely cut industrial-grade steel and shape diamonds.
Studies in the 1970s with diatomic molecules and noble gases led to the invention of a laser called the excimer laser. Biological matter and organic compounds absorb ultraviolet light from an excimer laser but rather than burning or cutting, the excimer laser adds enough energy to disrupt chemical bonds in the surface tissue causing them to disintegrate in a controlled manner.
In the 1980s IBM’s Rangaswamy Srinivasan observed that an ultraviolet excimer laser could make clean and precise cuts to organic tissue while leaving no thermal damage to the surrounding tissue. These features paved the way for lasers to be used in delicate eye surgeries. In 1983 Srinivasan and Stephen Trokel performed the first in situ photorefractive keratectomy using laser to correct eye defects.