The Maser

In 1954, Charles Townes and Arthur Schawlow invented the maser (microwave amplification by stimulated emission of radiation), using ammonia gas and microwave radiation – the maser was invented before the (optical) laser. The technology is very close but does not use a visible light. Lasers are what we now use for laser eye surgery.

On March 24, 1959, Charles Townes and Arthur Schawlow were granted a patent for the maser. The maser was used to amplify radio signals and as an ultrasensitive detector for space research.

In 1958, Charles Townes and Arthur Schawlow theorized and published papers about a visible laser, an invention that would use infrared and/or visible spectrum light, however, they did not proceed with any research at the time.

Many different materials can be used as lasers. Some, like the ruby laser, emit short pulses of laser light. Others, like helium-neon gas lasers or liquid dye lasers emit a continuous beam of light. See – How a Laser Works

Ruby Laser
In 1960, Theodore Maiman invented the ruby laser considered to be the first successful optical or light laser.

Many historians claim that Theodore Maiman invented the first optical laser, however, there is some controversy that Gordon Gould was the first.

Gordon Gould – Laser
Gordon Gould was the first person to use the word “laser”. There is good reason to believe that Gordon Gould made the first light laser. Gould was a doctoral student at Columbia University under Charles Townes, the inventor of the maser. Gordon Gould was inspired to build his optical laser starting in 1958. He failed to file for a patent his invention until 1959. As a result, Gordon Gould’s patent was refused and his technology was exploited by others. It took until 1977 for Gordon Gould to finally win his patent war and receive his first patent for the laser.

Gas Laser
The first gas laser (helium neon) was invented by Ali Javan in 1960. The gas laser was the first continuous-light laser and the first to operate “on the principle of converting electrical energy to a laser light output.” It has been used in many practical applications.

Robert Hall – Semiconductor Injection Laser
In 1962, Robert Hall created a revolutionary type of laser that is still used in many of the electronic appliances and communications systems that we use every day.

Kumar Patel – Carbon Dioxide Laser
The carbon dioxide laser was invented by Kumar Patel in 1964.

Hildreth “Hal” Walker – Laser Telemetry
Hildreth Walker invented laser telemetry and targeting systems.

Doctor Steven Trokel patented the Excimer laser for vision correction. The Excimer laser was originally used for etching silicone computer chips in the 1970s. Working in the IBM research laboratories in 1982, Rangaswamy Srinivasin, James Wynne, and Samuel Blum saw the potential of the Excimer laser in interacting with biological tissue. Srinivasin and the IBM team realized that you could remove tissue with a laser without causing any heat damage to the neighboring material.

Steven Trokel

New York City ophthalmologist, Steven Trokel made the connection to the cornea and performed the first laser surgery on a patient’s eyes in 1987. The next ten years were spent perfecting the equipment and the techniques used in laser eye surgery. In 1996, the first Excimer laser for ophthalmic refractive use was approved in the United States.

Note: It took the observations of Dr. Fyodorov in a case of eye trauma in the 1970’s to bring about the practical application of refractive surgery through radial keratotomy.

The operation itself involves creating a thin flap on the eye, folding it to enable remodeling of the tissue beneath with a laser. The flap is repositioned and the eye is left to heal in the postoperative period. This is essentially what laser eye surgery is all about.

Preoperative Lasik Surgery

Patients wearing soft contact lenses are usually instructed to stop wearing them 5 to 21 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts have been worn.^[6] Before the surgery, the patient’s corneas are examined with a pachymeter to determine their thickness, and with a topographer to measure their surface contour. Using low-power lasers, a topographer creates a topographic map of the cornea. This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and the locations of corneal tissue to be removed during the operation. The patient typically is prescribed and self-administers an antibiotic beforehand to minimize the risk of infection after the procedure.

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Better Quality Vision
Clinical studies have shown that Custom LASIK may improve not only what you see but also how well you see it. In the past, all vision was measured using a standard vision chart. If you could see the letters, the doctor would use that measurement for how well you could see. But now, with Custom LASIK, doctors are able to focus on the quantity as well as the quality of your vision. Many patients who have had Custom LASIK are reporting the ability to see clearer than ever before.

Higher Order Aberrations
Several types of visual imperfections, referred to as lower- and higher-order aberrations, exist within the eye and may affect your vision (the amount of these aberrations vary from person to person). Previously, only lower-order aberrations (such as nearsightedness, farsightedness and astigmatism) could be measured and treated. Higher-order aberrations may also have a significant impact on vision and have been linked to glare and halos. Now Custom LASIK may help to further customize your treatment of these higher-order aberrations that, in the past, could not be adequately treated with glasses, contacts or conventional LASIK treatments. Your doctor will recommend the best procedure for you based on your personal aberrations.

The Technology of Custom LASIK
Custom LASIK uses a wavefront analyzer to measure the way light travels through your eye. The wavefront analyzer creates a customized 3-D map of your eye that looks at your entire optical system. This map provides information about the unique visual characteristics of your eye which adds an additional level of data about your vision, enabling your surgeon to further customize your vision correction.

* Are all pre-operative and post-operative visits included in the cost of the initial procedure, or will additional charges for preoperative and postoperative visits apply?

* Can you choose the surgeon who will be operating on your eyes in advance, or will a surgeon be assigned to you the day of surgery?

* Who will be providing postoperative care?

* In the event of a complication, who would be providing emergency care?

Patients must determine for themselves the level of service they require and the quality of care they need in order to feel comfortable about the decision to undergo surgery and satisfied with outcomes.

Lasik Complications

According to an American Journal of Ophthalmology study of March 2006, the incidence rate of dry eyes from LASIK after the six month post operative healing period was 36.36%. The FDA (Food and Drugs Administration) website states that “dry eyes” may be permanent after laser eye surgery.

The high incidence of dry eyes necessitates a proper preoperative and post operative evaluation and treatment for dry eyes. There are a number of successful treatments for dry eyes including artificial tears, prescription tears and punctal occlusion. Punctal occlusion is accomplished by placing a collagen plug in the natural drain of the eye. Dry eyes, if left untreated can compromise the visual outcome and result in regression of the effect of LASIK or PRK.

The risk for a patient of suffering from disturbing visual side effects such as halos, double vision (ghosting), loss of contrast sensitivity (foggy vision) and glare after LASIK depends on the degree of ametropia before the laser eye surgery and other risk factors.For this reason, it is important to take into account the individual risk potential of a patient and not just the average probability for all patients. The following are some of the more frequently reported complications of LASIK:

* Surgery induced dry eyes
* Overcorrection or undercorrection
* Visual acuity fluctuation
* Halos or starbursts around light sources at night
* Light sensitivity
* Ghost images or double vision
* Wrinkles in flap (striae)
* Decentered ablation
* Debris or growth under flap
* Thin or buttonhole flap
* Induced astigmatism
* Corneal Ectasia
* Floaters
* Epithelium erosion
* Posterior vitreous detachment
* Macular hole

Complications due to LASIK have been classified as those that occur due to preoperative, intraoperative, early postoperative, or late postoperative sources.

Risks of Lasik Surgery

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This kind of laser eye surgery has helped plenty of people, but what you don’t always hear are the possibility of complications from eye surgery. Patients may lose ability to see in low-contrast situations (such as at night or in the fog), may be over- or under-treated, may develop dry eye syndrome, the results may diminish over time, and a small percentage of patients lose partial or full vision. Because this is a new technology (the first laser eye surgery procedure was approved in 1998), the long term effectiveness of LASIK is not known, and many doctors do not have adequate training in the machinery.

Before making the decision to go through with eye surgery, you should research and understand the problems that can occur and the procedure. There are many ways to do this, including going on-line or calling your doctor. Records of bad LASIK eye surgery and studies of surgical vision correction are easily available and may help you to make the decision.

Consulting a doctor may also be useful, but also be aware that some doctors are interested only in the money they receive. If you want more reliable, more unbiased, sources speak with relatives and friends that have undergone this kind of eye surgery. People you know will be happy to share with you both the problems and the successes.

Complications of Lasik Surgery

The consequences of a bad LASIK eye surgery can be very serious, devastating, and difficult to live with. One of the most serious consequences is the complete loss of eye sight. One wrong move made by the doctor and or faulty equipment can leave you with worse vision than when you arrived at the doctor’s office. Also, infection or other post-operative complications can lead to loss of eye sight.

Change in shape of the cornea is another serious complication that can occur which has implications on receiving and wearing contact lenses. If after the surgery the cornea is oddly shaped, you may have problems finding contacts that will fit. If this happens, special contacts, which will much more expensive than the average lens, would be required. A bad LASIK eye surgery can also result in constant burning and irritation, which may be treated with eye drops. However, if your doctor does not thoroughly explain the risks involved, find a new doctor!

Even if this type of eye surgery is widely used, and–if successful–can be beneficial, there is no guarantee you will not have a bad LASIK eye surgery experience, and the effects can be devastating and life-long.