LASIK has been around for about 35 years. The procedure was patented in 1989 and first performed on a human patient in 1990, making it one of the more well-established elective surgeries in modern medicine. In the decades since, the technology has gone through several major upgrades that have pushed patient satisfaction rates from 95% to nearly 99%.
The Patent and the First Surgery
On June 20, 1989, Iranian-American ophthalmologist Gholam A. Peyman was granted U.S. Patent 4,840,175 for a “Method for Modifying Corneal Curvature.” The patent described the core concept that still defines LASIK today: cutting a thin flap in the cornea, folding it back, reshaping the exposed tissue with a laser, and replacing the flap.
One year later, in 1990, Greek ophthalmologist Ioannis Pallikaris performed the first LASIK procedure on a human patient. The surgery combined two existing technologies: a mechanical blade called a microkeratome to create the corneal flap and an excimer laser to reshape the underlying tissue. Neither tool was new on its own, but Peyman’s insight was putting them together in a single procedure.
What Came Before LASIK
LASIK wasn’t the first attempt at surgically correcting vision. Radial keratotomy (RK), developed in the 1970s and popular through the 1980s, involved making small radial cuts in the cornea with a diamond blade to flatten it and reduce nearsightedness. The results were less predictable than what LASIK would later offer, and the cornea could continue to change shape over time.
Photorefractive keratectomy (PRK) arrived next and used the same excimer laser that LASIK would eventually adopt. The key difference is that PRK doesn’t involve a flap. Instead, the surgeon removes the outer layer of the cornea entirely and reshapes the tissue beneath it. This avoids flap-related complications but comes with more postoperative pain and a slower visual recovery. PRK is still performed today, particularly for patients whose corneas are too thin for LASIK.
How the Technology Has Changed
Early LASIK relied entirely on mechanical blades to create the corneal flap, which was the riskiest part of the procedure. Complications like uneven cuts, incomplete flaps, or flaps that detached completely were rare but real concerns. The first femtosecond laser system for eye surgery was designed in the early 1990s at the University of Michigan, and it eventually replaced the blade in what became known as “bladeless” or “all-laser” LASIK.
The femtosecond laser uses ultrafast pulses of light to create the flap instead of a physical blade. This gave surgeons far more control over the flap’s thickness, diameter, and hinge position. Thinner, more precise flaps meant fewer complications and opened the door for patients with thinner corneas who previously weren’t good candidates. The laser also produces stronger flap adhesion after surgery, lower rates of dry eye, and less risk of the outer corneal cells growing under the flap during healing.
The next major leap came in 2003, when the FDA approved the first wavefront-guided LASIK systems. Traditional LASIK corrected the same basic vision problems as glasses: nearsightedness, farsightedness, and astigmatism. Wavefront technology maps the unique optical imperfections of each individual eye, including subtle irregularities that standard prescriptions can’t address. This allowed for a truly customized correction. Two systems received FDA approval that year: one from VISX in May and one from Bausch & Lomb in October.
How Outcomes Have Improved Over Time
The cumulative effect of these technological upgrades is measurable. Before 2008, the average worldwide patient satisfaction rate for LASIK was 95%, which was already high for an elective procedure. After the widespread adoption of wavefront-guided treatments and femtosecond lasers, that number climbed to 98.7%, according to a large review published in the Journal of Cataract and Refractive Surgery in 2016. That places LASIK among the highest-satisfaction surgeries across all of medicine.
The improvement isn’t just about satisfaction surveys. Modern LASIK produces more predictable results, fewer side effects like glare and halos at night, and faster recovery times than the procedure available in the 1990s. A person getting LASIK today is benefiting from over three decades of refinement to a procedure that was already effective in its earliest form.
A Quick Timeline
- 1989: U.S. patent granted for the LASIK procedure
- 1990: First LASIK performed on a human patient
- Early 1990s: Femtosecond laser technology developed for ophthalmology
- 1999: FDA approves excimer lasers for LASIK use in the U.S.
- 2003: First wavefront-guided (custom) LASIK systems receive FDA approval
- 2010s onward: Bladeless, wavefront-guided procedures become the standard of care
From patent to present, LASIK has had roughly 35 years of clinical use and continuous improvement. The fundamental concept hasn’t changed since Peyman described it in 1989, but virtually every component of the procedure, from flap creation to laser precision to preoperative mapping, has been rebuilt at least once.