Refractive Surgery - PRK, LASIK in New York City
Dr. Sandra Belmont is one of the pioneering surgeons that worked with FDA protocols in studying the use of lasers to reshape the cornea for the purpose of decreasing or eliminating dependency on glasses and contact lenses. In its infancy, this surgery involved the application of relaxing incisions with a scalpel to reshape the cornea. But nowadays, thanks to the pioneering work of Doctor Belmont and a select few cornea specialists in the U.S., the laser has become the most efficient and least invasive means of performing refractive surgery.
Refractive surgery is the general term for various procedures that reshape the cornea so as to allow light to be efficiently focused on the retina. The history of refractive surgery dates back to the 1930s when Japanese ophthalmologist Dr. Tsutomu Sato developed the creation of spoke-like (radial) incisions on the cornea to decrease excessive curvature. With the use of a precision calibrated diamond knife, the technique, now known as Radial Keratotomy (RK), was further refined by Russian ophthalmologist Dr. Svyatoslav Fyodorov (c. 1960s). Common side effects however, included corneal instability, and fluctuations in vision. The possible compromise of the structural stability of the the eye was also a very real factor, a function of the profundity and number of incisions required for treatment.
These shortcomings were readily apparent. Colombian ophthalmologist Dr. Jose Barraquer had considered the possibility of a lamellar (layered) treatment as far back as the early 1940s. Acknowledged by his peers as the father of modern refractive surgery, Dr. Barraquer first used a microkeratome (Barraquer's own invention; a high precision surgical instrument that can shave off a disc or create a hinged flap of corneal tissue) to remove a disc of corneal tissue in 1949. The disc was then frozen, ground and polished on a cryolathe (another of Barraquer's inventions) to increase its refractive power and finally set back in place on the patient's cornea. The procedure, Automated Lamellar Keratoplasty (or ALK), proved to be very effective for high levels of myopia. Vision improves quite rapidly after ALK, although there is some initial fluctuation, and the healing time is also very fast.
In 1975, the first excimer lasers were developed for the purpose of etching micro chips. The high precision of the laser made it a natural for surgery. And in 1983, Dr. Steven Trokel first described the laser's potential for removing corneal tissue.
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