THE EXCIMER LASER EVOLUTION

December 2nd, 2008

Pioneers of the Excimer laser for Refractive Surgery took attendees on a journey through the quarter-century following the first clinical application of the Excimer laser to correct astigmatism on the 25th Anniversary of the Excimer laser. In a combined meeting with the International Society of Refractive Surgeons of the American Academy of Ophthalmology (ISRS/AAO) and the European society of Cataract and Refractive Surgeons (ESCRS) on Sunday, Stephen Trokel, M.D., N.Y., described how the laser was developed, how it evolved and then reached clinical application.

The Excimer laser was originally used for etching silicone computer chips in the 1970s. In 1982, Rangaswamy Srinivasin, James Wynne, and Samuel Blum, who worked in IBM research laboratories, found that tissue could be removed with a laser without causing any heat damage to the neighboring material. Dr. Trokel saw the potential for this to be applied to corneal refractive surgery. Charles Munnerlyn, Ph.D., Santa Clara, Calif., who was introduced to the Excimer laser in 1983 by Dr. Trokel, discussed the evolution of Excimer laser algorithms. It was Dr. Munnerlyn’s algorithms for required ablation depths that Dr. Trokel first used to begin performing the surgery on rabbits.

From a historical narrative, to the description of present applications of the Excimer laser, speakers moved on to discuss the future of the Excimer laser. Theo Seiler, M.D., Ph.D., Zurich, Switzerland, talked about the application of the laser on eyes that have undergone collagen cross-linking, which he said has a high efficacy and low complication rate. Presenting a case study, he said the combination of surface ablation and collagen cross-linking seems to be a reasonable approach though further research is needed.

As a sum up of the Excimer laser’s advancement through the years, Yaron S. Rabinowitz, M.D., Los Angeles, Calif., presented a video of the history of the laser, which will be made available for members of the Academy. This year’s Barraquer medal was awarded to Roger F. Steinert, M.D., Irvine, Calif., who delivered the Barraquer lecture titled, “Corneal Surgery is Refractive Surgery.”


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