ABSTRACT
The history of modern refractive surgery dates back to 1949 when Jose Ignacio Barraquer (Fig. 1.1) proposed the surgical modification of the refractive status of the eye by changing the radius of curvature of the anterior corneal surface1-4. He refined his ideas of performing lamellar keratoplasty for refractive purposes to correct spherical myopia. In 1958 Barraquer experimented on performing a free hand lamellar dissection of the corneal stroma to create a lamellar corneal disc and then attempted a refractive cut by removing stromal tissue from the bed (keratomileusis in situ) or the stromal surface of the corneal disc.1 He dissected the lamella to about half the thickness with the use of a corneal dissector or Paufique knife. He then considered freezing the lamellar corneal disc and used the cryolathe to modify the corneal disc. In the same year, he performed the first resection in situ using a prototype keratome with cutting angle of zero degree.
