LASIK

LASIK (Laser-Assisted In Situ Keratomileusis) combined two existing technologies—the microkeratome for creating corneal flaps and the excimer laser for reshaping tissue—into a procedure that would give millions of people freedom from glasses and contact lenses. The merger emerged from multiple research threads in the late 1980s, culminating in Ioannis Pallikaris's first published LASIK procedure.

The adjacent possible required the convergence of precision instruments and tissue ablation technology. In 1980, IBM researcher Rangaswamy Srinivasan discovered that excimer lasers—originally developed for computer chip production—could remove living tissue without thermal damage. By 1988, surgeons were using excimer lasers for photorefractive keratectomy (PRK), ablating the corneal surface directly. But PRK had drawbacks: significant post-operative pain and slow visual recovery as the epithelium regrew.

The breakthrough came from combining the excimer laser with the microkeratome, a precision blade that could create thin flaps of corneal tissue. Rather than ablating the surface, surgeons could lift a flap, reshape the underlying stroma with the laser, then replace the flap. This protected the nerve-rich epithelium, dramatically reducing pain and recovery time.

Ioannis Pallikaris at the University of Crete in Heraklion, Greece, pioneered this combination. He coined the term 'keratomileusis in situ' and performed the first published LASIK procedures in the early 1990s. Gholam Peyman had patented the LASIK concept in 1989, describing the flap-and-ablate technique that would become standard.

Marguerite McDonald had performed the first PRK procedure on March 25, 1988, at the LSU Eye Center in New Orleans—the foundation upon which LASIK would build. Steven Trokel at Columbia University had published key 1985 research on excimer laser effectiveness. The FDA approved PRK in 1995 and LASIK followed, becoming the dominant refractive surgery by the late 1990s.

The cascade reshaped vision correction. Over 10 million Americans have had LASIK, with success rates exceeding 96%. The procedure typically takes under 30 minutes and recovery is measured in days rather than weeks. While complications exist—dry eyes, night vision issues, and rare flap problems—LASIK has become one of the most commonly performed elective surgeries worldwide.

Path dependence established LASIK as the dominant modality, though alternatives like SMILE (Small Incision Lenticule Extraction) are emerging. By 2026, LASIK remains the gold standard for refractive surgery—Pallikaris's combination of blade and laser having freed millions from the constraints of corrective lenses.