Dr. Robert Maloney believes that a well-informed patient is key to successful vision correction surgery. He wants to be sure that you fully understand what you can expect from your procedure you choose. He wants to help you care for and preserve your eyesight in the best way possible. Here, you can find the information that you need to help you make informed choices about health care for your eyes.

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Although many pioneering contributions led to the development of modern refractive surgery, a key breakthrough occurred in the middle of the last century.

In 1949, Dr. José Barraquer of Bogotá, Colombia, developed the idea of lamellar corneal surgery (lamellar means “layered”). He discovered that lamellar surgery could reshape the cornea, enhancing the eye’s ability to focus. To do so, Dr. Barraquer removed a disc of the front portion of the cornea with an instrument called a microkeratome. The instrument was affixed to the eye through use of a vacuum ring; then the microkeratome shaved a small amount of the cornea at a predetermined depth. Dr. Barraquer froze the disc and then ground it into a new shape with a small lathe. He placed the newly shaped disc back on the cornea. The procedure of carving the cornea was called keratomileusis.

In 1987, Dr. Luis Ruiz, a protégé of Dr. Barraquer, used an automated microkeratome to reshape the cornea directly on the eye. This procedure, automated lamellar keratoplasty (ALK), was used to correct high levels of myopia and hyperopia. It is important to note that patients who have undergone these procedures—precursors to today’s laser vision correction—have not experienced long-term complications from the corneal reshaping.

Another advancement in LASIK surgery occurred in the late 1980s, when the excimer laser was first used on human eyes. The excimer laser uses a cool ultraviolet beam of light to vaporize tissue—that is, to break up the molecules—with exacting precision and without harming adjacent tissue. Each pulse of the excimer laser removes a mere 1/100,000 inch of tissue.

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