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The history of refractive surgery

Issue: January 1996

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mid-1800s

J. Ball advertises eye cup with spring-mounted mallet that flattens the cornea by striking it through the eyelid. "It restores your eyesight and renders spectacles useless," he claims(1)

1898

L.J. Lans, of The Netherlands, enunciates the basic principles of keratotomy.(1)

1939--1955

T. Sato and K. Akiyama, of Japan, establish principles of transverse and radial keratotomy in rabbits and man; poor results with posterior keratotomy. (2)

1972

S. Fyordorov, of the USSR, includes multiple ocular variables to anterior keratotomy, including smaller clear zones, to tailor keratotomy for each patient.(2)

1973

Charles Brau and James Ewing, stimulated by Donald Setser, start working on rare halides to produce laser action.(3)

1975

Stuart Searles produces first excimer laser action by bombarding a medium of xenon-bromide with an electron beam gun.(3)

1978--1980

Bores, Myers and Cowden start keratotomy in the United States; added centrifugal and deepening incisions.(2)

1979

First commercial system made by Tachisto.(4)

1981

• IBM researcher R. Srinivasan patents "photoetching" using the excimer laser.
• Taboada, Mikesell and Reed show that corneal epithelium is extremely sensitive to the 193-nm light emitted by the ArF excimer laser.(5)

1983

• First medical paper published by Stephen Trokel on the potential of photorefractive keratectomy (PRK) for humans.
• First experiments on the cornea done by Trokel and Srinivasan.(4)
• PRK patent filed by Trokel in 1983; issued in 1990.(4)
• PRK patent filed by Francis L'Esperance in 1983; issued in 1987.(3)

1985-1986

Taunton Technology (1986), VisX (1986) and Summit Technology Inc. (1985) founded.

1985

Theo Seiler, of Germany, performs first excimer laser phototherapeutic keratectomy (PTK) in sighted eye.

1987

• L'Esperance performs first PRK in United States on blind eye as first Food and Drug Administration (FDA) trial begins.(3)
• L'Esperance performs first PRK in United States on sighted eye (20/20) eventually enucleated for malignancy.(3)

1988

Marguerite McDonald is first to achieve successful refraction with PRK on normally sighted myope.

1993

Pillar Point Partners founded.

1994

• FDA Ophthalmic Device Panel recommends that FDA approve Summit excimer laser for PTK.(3)
• FDA Ophthalmic Device Advisory Panel recommends that FDA approve VisX excimer laser for PTK.
• FDA Ophthalmic Device Panel recommends that FDA approve Summit laser for PRK, with conditions.

1995

• FDA issues pre-market approval to Summit and VisX lasers for PTK.
• FDA approves Summit laser for PRK; issues approvable letter to VisX for PRK.

Sources:

1. Sanders, DR, Hofmann RF, Salz JJ, eds. Refractive Corneal Surgery. Thorofare, NJ: SLACK Inc.; 1986.
2. Waring, GO. Refractive keratotomy for myopia and astigmatism. St. Louis: Mosby-Year Book, Inc.: 1992.
3. Provided by Francis L'Esperance, MD.
4. Provided by Stephen Trokel, MD.
5. Stein, HA, Cheskes, AC, Stein, RM. The Excimer: Fundamentals and Clinical Use. Thorofare, NJ: SLACK Inc.; 1995.