Bladed-LASIK Utilizing a Microkeratome
Part 3 of a 4-Part Series
In 1963, Dr. Jose Ignacio Barraquer, the same surgeon introduced to you in part 2 of this blog series who invented keratomileusis, also invented the firstmicrokeratome[i] used in Laser-Assisted-In-Situ-Keratomileusis (LASIK) laser vision correction. This was the first of many microkeratomes to follow.
The microkeratome is an instrument which utilizes an oscillating blade to create a corneal flap during the LASIK surgery. It took many years for the idea of LASIK, introduced by Dr. Barraquer with the invention of the microkeratome, to be adopted in North America. The excimer laser was FDA approved for use in LASIK laser vision correction in October of 2000[ii].
In the LASIK surgery, a corneal flap is created, using a microkeratome in this method, and then lifted. The corneal bed underneath the flap is reshaped using the same excimer laser utilized in PRK, and then the flap is laid back down. LASIK is an advancement because surgeons are able to leave the corneal epithelium intact, as opposed to PRK, in which the epithelium is removed. This advancement revolutionized refractive surgery because it brought with it an immediate return of vision.
Some surgeons are still utilizing a microkeratome to create LASIK flaps for their patients. After carefully studying the results of the IntraLase Laser, and only after multiple generations of the technology was made available, Dr. Mandel was finally convinced that the all-laser method created superior LASIK flaps compared to the microkeratome blade. Dedicated to providing his patients with the highest quality of care, as well as the latest technology, Dr. Mandel is now exclusively doing blade-free LASIK using the IntraLase Femtosecond Laser to create his LASIK flaps. This technology will be discussed in depth in the next, and final, blog in this series.
Why all this talk about the history of laser vision correction? It’s not only fascinating; it should also provide our patients with an added level of comfort when considering this elective procedure, as it illustrates that there is long term data available. LASIK is simply a combination of keratomileusis (developed in the 1950’s) and the excimer laser (FDA approved in 1996 for PRK). In fact, 31.4 million laser vision correction procedures have been performed worldwide to date, making it the most common elective vision procedure in the U.S.[iii] To put it simply, many have gone before you, and now see their world more clearly without the need for eyeglasses or contact lenses!