History

The first refractive surgeries are thought to have been performed in ancient Greece. These crude surgeries involved removal of cataracts — the clouding of the lens in the eyes. In the 1850s, the first refractive lensectomy was performed. During this procedure, the lens of the eye was removed for purposes of correcting myopia, which is commonly known as nearsightedness. In the late 19th century, the first corneal surgery for correction of astigmatism, or an irregularly shaped cornea, was performed. Astigmatism was reduced with a horizontal incision in the corneal stroma.

Modern day ophthalmic surgeons have been performing refractive surgery for the treatment of hyperopia, or farsightedness, myopia, and astigmatism for many years. The past decades have produced rapid change and growth by means of refined techniques and the emergence of laser vision surgery.

In 1978, a refractive procedure called radial keratotomy, or RK, was introduced in the United States. RK involves making a number of cuts in the cornea to change its shape and correct refractive errors. Following the introduction of RK, providers routinely corrected nearsightedness, farsightedness, and astigmatism, using various applications of incisions on the cornea.

In the 1980s, a new type of laser, called the excimer laser, was developed. Though originally used to etch computer chips, ophthalmologists began using the excimer laser successfully in refractive surgery techniques to remove very precise amounts of tissue from the eye’s surface. Excimer lasers revolutionized refractive surgery by providing a degree of safety and precision that was previously unattainable with other techniques. Nearly all lasers used today are excimer lasers.

The first generation lasers were called “broad beam lasers.” The results were satisfactory and these lasers are still occasionally used today. Later, scanning lasers were developed where a small spot or strip of laser beam rapidly scans the cornea. Scanning lasers are more commonly used today.