ABSTRACT
Microkeratomes have evolved from suction rings and moving blades that were difficult to operate to more user-friendly devices currently utilized in LASIK refractive surgery. The early microkeratomes used by José Ignacio Barraquer were limited to the treatment of high myopia. Barraquer’s technique, involving the creation of a central lenticule with a manual microkeratome, freezing this section, and carving the deep portion with a lathe, according to the amount of refractive error, had several technical limitations and was associated with numerous complications. Complications of this technique resulted from difficulties in mastering the microkeratome and cryolathe and included lenticular damage, persistent corneal haze, irregular astigmatism, under-and over-correction, and regression (1). Innovations to address this problem, including Swinger’s technique, in which he did not freeze the back side of the lenticule (1-4), and Ruiz’s in situ method for manually removing corneal stroma deep to the flap (5), were particularly important milestones that led to the development of current microkeratomes.
