A 360 degree vision of laser eye surgery

Read on to know the history and current day scenario

Laser-assisted in situ keratomileusis (LASIK) is the most commonly performed laser eye surgery to treat myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. Like other types of laser refractive surgery, the LASIK procedure reshapes the front surface (cornea) of the eye to enable light entering the eye to focus on the retina without glasses or contact lenses.
LASIK typically is pain-free and it requires only about 15 minutes to treat both eyes. Vision improvement is immediate and often stabilizes in as little as 24 hours. The technique exploded over the last few decades to become one of the world's most popular elective procedures because the procedure involves relatively minimal risks at affordable costs for immediate vision improvement, decreased risk of infection, and heightened visual acuity in comparison to conventional surgery. By 2017, such surgeries were around 30 million and increasing every minute as it changed people's lives.
Laser therapies now known as refractive surgery had its origins in the work of Dr. Lendeer Jans Lans who theorized that cuts made in the cornea could rectify corneal curvature and cure astigmatism. He went on to publish a theoretical paper in 1896. Working on this theory, Dr Jose Barraquer in late 1930s had proposed that refractive errors like myopia and hypermetropia could be corrected by modifying the shape of cornea.
Around the same time, a Japanese ophthalmologist Tsutomu Tsato first practiced refractive surgery on war pilots making incisions to the cornea radically 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 Svyatoslav 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. This procedure was developed in the wake of an accident during which glass particles got lodged into the victim's eyes. To save the man'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 resembling the spokes of a wheel. After the cornea healed he found that the boy's visual acuity had improved significantly.
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. It gained popularity in India for vision correction since the 1980s with IBM Thomas J. Watson Research Center's Rangaswamy Srinivasan pioneering the discovery of excimer laser ablative photodecomposition of human and animal tissue, which laid the foundation for PRK and LASIK or laser refractive surgical techniques that have revolutionized vision enhancement. In 1983 Srinivasan and Stephen Trokel performed the first in situ photorefractive keratectomy using laser to correct eye defects.
Phacoemulsification is a cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye.
Phacoemulsification is a modern cataract surgery method in which the eye's internal lens is emulsified with an ultrasonic hand piece and aspirated from the eye. Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber. It was introduced in 1967 by American ophthalmologist, Charles David Kelman and Slovenian ophthalmologist Anton Banko. Dr Kelman had also invented many medical devices, instruments, implant lenses and techniques used in cataract surgery. In 1960s, he began use of cryosurgery to remove cataracts and repair retinal detachments.
Representative image
Image: Representative image
Cryosurgery for cataracts remained in heavy use until 1978, when phacoemulsification, a procedure Kelman developed along with Dr Banko in 1967, became the modern standard treatment. Dr Banko had set up Surgical Design Corporation in New York in 1968 besides being known for ocular surgery by using vitrectomy instrument. Recent advances in phacoemulsification technology involve combining the ultrasonic and I/A irrigation sleeve into a single disposable hand piece. This design reduces manufacturing costs, eliminates the risk of infection and provides better surgical outcomes.
After commissioning of VISION-2020 India in Arunachal Pradesh, Ramakrishna Mission Hospital eye surgeon Dr Lobsang Tsetim had played a vital role for prevention of avoidable blindness and visual impairment in the state by conducting numerous phaco surgeries since 2005. Thus, he was among the three Indian eye surgeons to be nominated for the Eye Health Heroes Award-2016 by International Agency for Prevention of Blindness. LASIK surgery is very costly in comparison to Phaco surgery, Dr Tsetim stated.
There are many eye clinics across in North East India, but Sri Sankaradeva Nethralaya in Guwahati set up in 1994 by Sri Kanchi Sankara Health and Educational Foundation is very famous. It was dedicated to the nation in 1995 by then Prime Minister P.V. Narsimha Rao. However, the presence of numerous eye clinics confuse the treatment seekers for which Fit Northeast envisages to offer telemedicine service so that people get treatment from a specialist doctor of their choice at affordable prices and convenient time.
Stay tuned to Fit Northeast ...... the telemedicine initiative shall roll out in some months



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