This month marks a significant milestone – 30 years since the first laser eye surgery using the LASIK method, performed by Chief Surgeon Dr. Petr Novák. The procedure not only represented a breakthrough moment in Dr. Novák’s career but also a defining chapter in the history of Czech refractive surgery. When first introduced in 1995, LASIK was a revolutionary technique that opened the door to modern, precise, and safe correction of refractive errors.
To commemorate this anniversary, Dr. Novák shares his memories of the very first LASIK procedure, reflects on the early days of laser technology, and discusses how ophthalmic surgery has evolved over the past three decades.
What were the circumstances surrounding your first LASIK surgery in 1995?
“In 1995, excimer laser surgeries were still uncommon. Just one private clinic in Prague had been offering PRK procedures since 1993. The LASIK method was performed at only a few centres across Europe and had not been approved at all in the United States.
In August 1995, several colleagues and I completed specialized training at Technolas in Munich. Consequently, in September, the Technolas 116 system was installed at the Ophthalmology Department of the University Hospital Královské Vinohrady, where a new refractive laser centre was established under the name ELAS.
Initially, we performed procedures using the then-common PRK method. The real breakthrough came in October — with our first LASIK surgery.”
Do you remember how you felt that day? Was it nerves or excitement?
“I was very honoured to be entrusted with the first surgery. There was nervousness all around, but I knew I was taking part in something truly remarkable.”
Do you recall the patient’s and the team’s reactions following the first surgery?
“I remember that the patient only learned afterwards that he had been the very first person to undergo the LASIK procedure. That decision was made intentionally, we didn’t want to cause unnecessary anxiety at such an important moment.”
What made the laser technology so groundbreaking at that time?
“With PRK, the healing and recovery process took about three months. We operated on one eye first and only months later on the second eye. LASIK, on the other hand, allowed for both eyes to be operated on at the same time, with basic healing completed by the following day. Patients could return to their everyday activities almost immediately. It was truly revolutionary.”
What’s your take on the fact that thirty years have passed since your first LASIK surgery?
“At the very least, it means that I’ve been around for a while,” he laughs. “But seriously, the fact that LASIK remains in use three decades later, with only minor improvements, speaks volumes about the brilliance of its design. It’s simply a genius concept.”
What is one of the most memorable moments over the years?
“I experience it every week. I always insist on personally examining patients the day after surgery. Hearing their words — ‘From the moment I opened my eyes, I could see… hair on the floor, signposts I never noticed before’ — it never gets old.”
How does it feel to witness a patient seeing clearly for the very first time after surgery?
“It’s wonderful. Most patients perceive the change almost instantly, right there on the operating table. Watching their nervousness transform into excitement and relief is incredibly rewarding.”
How have technologies and procedures evolved over time, from the first LASIK surgeries to today’s iDESIGN iLASIK, for example?
“The core principle remains the same, reshaping the cornea with an excimer laser beneath a flap (lamella).
When I started, the lamella was created mechanically using a microkeratome with an oscillating blade. Today, we use a femtosecond laser, which is much safer and more precise. The laser itself has also evolved — it now features a variable beam width, allowing for highly accurate modelling of even complex corneal shapes.
The iDESIGN iLASIK represents the most advanced approach: it begins with a detailed analysis of all optical imperfections in the eye, from which the optimal corneal shape is designed and then precisely created with the excimer laser.”
How do you think public perception of laser eye surgery has changed over the past thirty years?
“For most people, laser eye surgery has become a completely routine way of achieving life without glasses. Over the past three decades, thousands have acquired clear vision thanks to this technology — they are its best advertisement.
It doesn’t cease to surprise me, however, that some of my colleagues remain sceptical, even suspicious, of refractive surgery. I find this simply incomprehensible.”
What would you describe as the greatest advancement in ophthalmic surgery over the past thirty years?
“I personally find the continuous development of surgical methods and the vast expansion of treatment options as the greatest step forward. Today we can correct almost any refractive error more precisely and gently than ever before.”
How do you think eye surgery will evolve over the next 10–20 years?
“Over the next 10–20 years, I expect, on the one hand, further refinement of existing techniques, but on the other hand, also the arrival of entirely new technologies. What kind? Let’s wait and see.”
What would you like to see facilitated in the future that isn’t possible just yet?
“Modern medicine should focus primarily on prevention. There is ongoing research on how to prevent the development of refractive errors in childhood and that would truly be amazing.”
After so many years, what do you continue to enjoy and what motivates you?
“From the moment I started studying medicine, my dream was to become a surgeon. Surgery has its magic, you see the results of your work almost instantly. At the same time, you carry enormous responsibility for human lives, which gives this profession a deeper meaning.”
What advice would you give to young doctors embarking on a journey towards becoming eye surgeons?
“Alongside skill, cultivate patience and humility. Only then will you experience that extraordinary feeling when someone sees clearly once again as a result of your work.”