What did the trial errors and outcomes of LASIK look like when it was first developed?

LASIK technology has come a long way in the last 25 years. LASIK results today are leaps and bounds better than they were during the original trials. But even if our capabilities with modern technology make the old days look ancient, the first steps are what got us there.

Joel Hunter, MD
Joel Hunter, MD
Refractive Surgeon, Hunter Vision Updated 11/04/20 1:34 PM

There was a time when cameras first started showing up in cell phones. If you were born anytime before the mid-’90s, then you were there for this. Remember those first cameras? The photos looked like Monet paintings. You had to interpret them. And we were *amazed* by the technology. A digital camera, once the domain of photographers, spies, and nerds, was now in the palm of our hand. And it was part of a phone that would let us send that photo — through a complicated process more complicated than launching a satellite — to an email address. Marvelous.

Fast forward to today, those old photos look like they were taken with a potato. The cameras in our phones take better photos than almost any camera from those days. We get better photos from our phones than from cameras whose whole job is being a camera. And since those are the photos we see every day, those old-timey mid-’90s photos look so ancient that it evokes a feeling of nostalgia. It’s the only explanation I can come up with for Instagram filters.


LASIK in the ‘90s

25 years in the world of technology is an enormous length of time. This is equally true for camera phones and LASIK. The standards for the original FDA approval for laser eye surgery (PRK at that time) in 1995 are so ancient these days that it evokes a feeling of nostalgia. Wait no, not nostalgia, I mean dread. Or maybe gratitude, because LASIK results today are so much better than they were during the original trials. The difference in camera phones doesn’t even compare. It’s more like the difference between horseback riding and a new car.

To get approval, the standard of success was 20/40 vision in 85% of patients. And that was just for patients with easy myopic prescriptions. 20/40! Egads! To put that in perspective, I literally cannot remember a time a patient in that prescription range ended up at 20/40 after LASIK. When someone needs an enhancement after LASIK in our clinic, their vision is still almost always 20/25 or better, but just not quite as good as it could be.

Beyond that, the original FDA approval standard was that only 1 in 20 patients could lose two lines of best-corrected vision on the eye chart. My heavens above! That means that 1 in 20 people who started out with 20/20 vision in their glasses could end up 20/30 *still in glasses* after LASIK. I have never had this happen to a single patient out of many thousands. I’m not saying that because I’m Dr. Awesome Von Smugness M.D. I’m saying it because Hunter Vision opened in 2010, when the technology was already 15 years better. Those 15 years yielded changes in tech that made the standard from the early days become so obsolete that it’s unimaginable now.


How Far LASIK Has Come

In conclusion, the trials of early laser eye surgery read like a bone-chilling, scary story when read with modern eyes. And yet, there is a key point to those early days that we should realize. It became wildly popular. People were flying to Canada to get laser even before it was approved in the US. It was in that time, with those standards, that laser eye surgery grew from a niche, rare procedure into one being performed over a million times a year in the US. People could gain eyes that saw without glasses! Vision once only held by fighter pilots and eagles was now there for the taking! What was a digital camera in their phone compared to that?

We’ve come so far since then. But even if our capabilities with modern technology make the old days look ancient, the first steps are what got us there. It was exciting and new, and so it grew. A good camera phone back then brought the same (or probably more) joy as a new one does today. People were happy with laser back then, and they are happy with it today. But, goodness, I am glad we live in today. Being happy is great at any point, but the 20/15 super vision kind of happiness is a better world to live in than 20/40 happiness. We can feel nostalgia for the past, but no one needs to be content with the technology of those days. If you find yourself longing for those days, that’s what Instagram filters are for.


Author:Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Orlando Clinic in Florida.A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.


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