It was not until the early 1990s that some of the corneoplastic principles proposed by José Ignacio Barraquer were translated into widespread clinical and surgical practice worldwide. There were limitations in precision with the available mechanical microkeratomes at that time, but they were good enough to create non-refractive lamellar cuts though insufficient to design predictable refractive cuts (freeze and non-freeze keratomileusis). The incorporation of the Excimer laser in the 1980s for precise anterior corneal refractive ablations1 was the trigger for the revolutionary concept of laser in situ keratomileusis (LASIK).2 Since then, significant improvements in surgery and evaluation have been seen, which have also yielded dividends for corneal surgeons whose practice focuses on therapeutic corneal and anterior segment surgery.

A good …