LASIK

Also known as: laser-assisted in situ keratomileusis

Definition

LASIK — laser-assisted in situ keratomileusis — is refractive eye surgery in which an ophthalmologist cuts a thin hinged flap in the cornea with a femtosecond laser or microkeratome, folds it back, and uses a programmed excimer laser to vaporize and reshape the underlying corneal stroma, correcting the eye’s focusing power so light lands properly on the retina. The surgery treats myopia, hyperopia, and astigmatism, takes about 10 to 15 minutes per eye, needs no stitches — the flap self-adheres within minutes — and most patients resume normal activity within a day or two. (Wikipedia — LASIK, AAO — LASIK)

The name descends from José Barraquer’s mid-twentieth-century keratomileusis — literally “carving of the cornea” — fused with the cold ultraviolet excimer laser developed at IBM in the early 1980s. Reference databases now fix the procedure’s identity across the biomedical record, from Wikidata (Q278846) to the Medical Subject Heading “Keratomileusis, Laser In Situ” (D020731) introduced in 2000. By 2018 about 9.5 million Americans had undergone the procedure, within more than 40 million performed worldwide from 1991 to 2016. (Wikidata — LASIK, Wikipedia — LASIK)

Identities

Source	Identifier	URL
Wikipedia	LASIK	https://en.wikipedia.org/wiki/LASIK
Wikidata	LASIK (Q278846)	https://www.wikidata.org/wiki/Q278846
DBpedia	LASIK	https://dbpedia.org/page/LASIK
ProductOntology	N/A	N/A
Wiktionary	LASIK	https://en.wiktionary.org/wiki/LASIK
Library of Congress Subject Headings (LCSH)	N/A	N/A
MeSH	Keratomileusis, Laser In Situ (D020731)	https://www.ncbi.nlm.nih.gov/mesh/D020731
NCBI Taxonomy	N/A	N/A
AGROVOC	N/A	N/A
Google Scholar	LASIK outcomes complications excimer laser refractive surgery	https://scholar.google.com/scholar?q=LASIK+refractive+surgery+outcomes
ConceptNet	N/A	N/A
OpenCyc	N/A	N/A

Also Known As

laser-assisted in situ keratomileusis

Examples and Analogies

A prescription carved into the cornea: LASIK is to eyeglasses what engraving is to a paper label — instead of resting a corrective lens in front of the eye, the surgeon reshapes the eye’s own front window by removing microscopic layers of tissue, so the correction travels with the patient and cannot be lost at the gym.
Lifting a carpet tile to level the floor: the flap is like lifting a carpet tile to grind the concrete beneath — the excimer laser ablates the stroma in fractions of a micron, then the flap is laid back and adheres without stitches, leaving no suture line to irritate the eye. (AAO — LASIK)
From the knife to the light beam: the surgery’s two-step history — Barraquer’s 1950s mechanical microkeratome for the flap, IBM’s 1979–1982 discovery of 193-nanometer excimer ablation, and their fusion by Ioannis Pallikaris into the modern flap-plus-laser procedure — is a case study of one operation built from two unrelated technologies, mechanical and photochemical. (Wikipedia — LASIK)
Verified clinical data points:
Satisfaction: 92–98 percent across surveys; a 2008 meta-analysis of 309 articles (1988–2008) found 95.4 percent
Acuity: 97 percent of patients reach 20/40 uncorrected; 62 percent reach 20/20
Duration: about 10–15 minutes per eye; normal activity typically resumed within a day or two
Dry eye: roughly 95 percent experience it initially; about 17 percent still need daily drops at five years
PROWL findings: up to 46 percent of previously asymptomatic patients reported a new visual symptom at three months (halos in up to 40 percent); fewer than 1 percent reported “a lot of” difficulty with daily activities
Scale: about 9.5 million Americans treated by 2018; over 40 million procedures worldwide, 1991–2016

Usage Scenarios

1. Correcting Common Refractive Errors

The standard use is freedom from glasses or contact lenses for everyday myopia, hyperopia, and astigmatism: candidates should be at least 18 (ideally over 21), with a prescription stable for at least a year, adequate corneal thickness, healthy eyes, and none of the disqualifying conditions — keratoconus, thin or scarred corneas, severe dry eye, poorly controlled diabetes, or pregnancy. (AAO — LASIK, Wikipedia — LASIK)

2. Variant and Escalating Technologies

Surgeons match the technique to the eye: wavefront-guided LASIK uses sensor data to correct higher-order aberrations and reduce halos, topography-assisted LASIK (first US device approval September 13, 2013) maps the cornea’s surface, and all-laser flap creation (femtosecond, developed 1997) replaced the mechanical blade. (Wikipedia — LASIK)

3. High Prescriptions and Non-LASIK Alternatives

Philippine clinics illustrate the laddering of options around the flap: Shinagawa’s menu runs from SMART, ULTRA, Z PRIME, and PresbyMAX LASIK through TransPRK and CLEAR (a bladeless surface treatment) to implantable collamer lenses for patients whose prescriptions are too high or corneas too thin for laser ablation. (Shinagawa Philippines)

4. Lifestyle and Occupational Demand

The quick-recovery profile — a screening, a ten-minute procedure, and return to work within days — suits contact-lens-intolerant professionals, athletes, and the shift workers of the Philippine BPO sector, the demand pattern this wiki’s Shinagawa Lasik and Aesthetics entry documents in the local market. (Wikipedia — LASIK, Shinagawa Philippines)

5. Medical Tourism Packaging

LASIK anchors the ophthalmologic offering of Philippine medical tourism alongside cataract surgery, marketed to foreigners and returning overseas Filipinos with Japanese-standard screening and warranty terms — Shinagawa advertises up to ten years of LASIK warranty and more than 1.4 million procedures group-wide. (Shinagawa Philippines)

Strategies

Screen before you cut: the discipline of the modern practice is triage — wavefront analysis, corneal thickness mapping, and stability checks that divert keratoconus suspects, thin corneas, and unstable prescriptions to surface ablation or lens implants instead. (AAO — LASIK, Wikipedia — LASIK)
Technology laddering: clinics stage their menu from flap-based LASIK through surface treatments (TransPRK, CLEAR) to intraocular lenses, so no patient is forced into the wrong tool for their anatomy. (Shinagawa Philippines)
Expectation management: honest consent includes the presbyopia caveat — LASIK cannot stop the mid-forties need for reading glasses, and monovision (one eye set for near, one for far) should be trialed with contact lenses first. (AAO — LASIK)
Record-keeping for the rest of life: patients should keep their pre- and post-operative measurements (the “K card”) because flap data matters for future cataract surgery or retreatment decades later. (AAO — LASIK)
Retreatment planning: under- and over-correction are treated as manageable residuals — glasses, contacts, or a touch-up laser enhancement — rather than failures of the primary surgery. (AAO — LASIK)

Security and Safety Measures

Hard contraindications: keratoconus and other ectatic disorders, thin corneas, Fuchs’ dystrophy, severe dry eye and Sjögren’s syndrome, uncontrolled autoimmune disease, retinal tears, blepharitis, and pregnancy or nursing exclude patients from the flap-based route; large pupils raise glare and halo risk. (Wikipedia — LASIK, AAO — LASIK)
Flap protection for life: the flap adheres without sutures but is a permanent structural seam — traumatic dislocation has been reported as long as thirteen years after surgery, so eye-trauma protection matters indefinitely. (Wikipedia — LASIK)
Dry-eye surveillance: nearly all patients have early dryness; management runs from artificial tears to anti-inflammatory drops, with about 17 percent still using daily lubricants at five years. (Wikipedia — LASIK)
Infection-control benchmarks: published complication rates — flap complications around 0.244 percent, infection around 0.04 percent — define the sterility standards surgical suites must hold. (Wikipedia — LASIK)
Regulated delivery in the Philippines: devices and clinics operate under the national regulatory regime for ambulatory surgical facilities and registered equipment — the framework this wiki’s Shinagawa Lasik and Aesthetics entry describes, with procedures performed by PRC-licensed ophthalmologists. (Shinagawa Philippines)
Consumer-financing caution: Philippine laser centers commonly offer installment plans — Shinagawa up to 24 months at 0 percent interest — so the financial commitment, not only the surgical risk, belongs in the consent conversation. (Shinagawa Philippines)

Historical Context

LASIK is a Colombian-Indian-American-Greek construction. In the 1950s José Barraquer in Bogotá invented the microkeratome and keratomileusis, cutting thin corneal flaps to reshape refraction; at IBM, Srinivasan, Blum, and Wynne discovered ultraviolet excimer ablation of organic tissue between 1979 and 1982, and in 1983 Stephen Trokel tested the excimer laser on corneas. Gholam A. Peyman patented the excimer corneal procedure (applied 1985, granted 1989), FDA trials began in 1989, and in 1992 the Greek ophthalmologist Ioannis Pallikaris introduced the combined flap-and-laser procedure at ten US centers — the surgery the acronym LASIK now names; the Kremer Excimer Laser won the first FDA approval specifically for LASIK in 1998, femtosecond all-laser flap creation followed from 1997, and topography-assisted LASIK gained its first US approval on September 13, 2013. (Wikipedia — LASIK)

The procedure’s record since is one of mass adoption and measured reassessment: 95.4 percent satisfaction in the 2008 meta-analysis, but US volumes falling from about 1.5 million in 2007 to 604,000 in 2015 as pricing, candidacy conservatism, and quality-of-life reporting cooled the boom. In the Philippines, the surgery’s arrival as a consumer offering is identified with the 2010 entry of Japan’s Shinagawa group, whose Philippine operation markets Japanese-standard LASIK — the market-shaping episode this wiki’s Shinagawa Lasik and Aesthetics entry records — and refractive surgery now anchors the ophthalmologic line of the medical-tourism industry this wiki’s separate entry covers. (Wikipedia — LASIK, Shinagawa Philippines)

Challenges and Controversies

Quality-of-Life Outcomes and the PROWL Studies

The FDA’s PROWL studies complicated the satisfaction narrative: up to 46 percent of patients without pre-operative symptoms reported a new visual symptom three months after surgery — halos in up to 40 percent — and up to 28 percent reported new dry eye, even though fewer than 1 percent reported “a lot of” difficulty with daily activities; the figures are now central to informed-consent practice. (Wikipedia — LASIK)

Corneal Ectasia

The most feared complication is post-LASIK ectasia — a progressive corneal bulging resembling keratoconus triggered when too-thin corneas or forme fruste keratoconus slip through screening — the reason candidacy rules on corneal thickness and topography have hardened into the field’s gatekeeping doctrine. (Wikipedia — LASIK)

Lifestyle-Surgery Marketing Versus Surgical Consent

In the Philippine market LASIK is marketed as a fast, lifestyle-enhancing upgrade — ten-minute procedures, warranties, installment plans — a framing that public-health commentary contrasts with the operation’s status as real surgery with permanent structural change, the tension this wiki’s Shinagawa entry documents in the local normalization of laser eye surgery. (Shinagawa Philippines)

Cost and Access

Philippine clinics generally do not publish fixed prices, quoting after screening and promoting payment plans instead — up to 24 months at 0 percent interest at Shinagawa — which keeps the procedure’s cost opaque at the point of advertising and marks it as an elective, out-of-pocket surgery beyond routine public-health coverage. (Shinagawa Philippines)