term impact of the city’s economic revival is on the
labor movement. Las Vegas maintains a strong labor
union presence, and most of the new megaresorts
have large numbers of unionized employees, typi-
cally belonging to the Culinary Workers Union. The
union was strengthened in Nevada by the mega-
resorts’ growth.
Further Reading
Gottdiener, M., Claudia C. Collins, and David R.
Dickens.Las Vegas: The Social Production of an All-
American City.Malden, Mass.: Blackwell, 1999. A
sociological study of the modern city, with atten-
tion to the role of the megaresorts and their fi-
nancing.
Moehring, Eugene P.Resort City in the Sunbelt: Las Ve-
gas, 1930-2000.Reno: University of Nevada Press,
- A scholarly history of the city’s growth. The
epilogue summarizes developments in the mega-
resort era.
Smith, John L.Sharks in the Desert: The Founding Fa-
thers and Current Kings of Las Vegas.Fort Lee, N.J.:
Barricade Books, 2005. Biographical sketches of
the past and present hard-dealing men who built
Las Vegas, by the foremost columnist for the city’s
largest newspaper.
Emily Alward
See also Architecture; Cirque du Soleil; Hobbies
and recreation.
LASIK surgery
Definition Laser eye surgery that corrects
nearsightedness, farsightedness, and
astigmatism
During the 1990’s, LASIK surger y allowed many people
with myopia to throw away their eyeglasses or contact lenses
after undergoing a quick and relatively easy surgical proce-
dure.
Myopia (nearsightedness) is a common visual de-
fect. In the 1950’s, Colombian ophthalmologist José
Ignacio Barraquer first suggested that myopia could
be solved through surgery on the cornea known as
keratomileusis (derived from the Greekkeratos, “cor-
nea,” andmileusis, “carving”). Surgeons and re-
searchers were skeptical, however, particularly about
the safety of the surgery. In 1977, Richard Troutman
introduced keratomileusis to the United States, but
the procedure remained difficult to perform cor-
rectly and easily. In 1989, Lucio Buratto performed
the procedure using the excimer laser. Since a laser
does not generate heat, it can sculpt extremely thin
layers of tissue. Buratto’s innovation allowed the cut
to be made with great precision, few complications,
little surgical trauma to the eye, and little stress for
the surgeon. Moreover, the surgery generally took
less than thirty minutes. In 1995, the U.S. Food and
Drug Administration (FDA) approved laser-assisted
in situ keratomileusis (LASIK) surgery for nearsight-
edness. By the end of the decade, more complicated
LASIK procedures had been approved for hyper-
opia (farsightedness) and astigmatism, but they
were less commonly performed.
Myopic keratomileusis aims to flatten the central
cornea by increasing the radius of curvature of
the anterior cornea by removing a specific amount
of stromal tissue within a specific optic zone.
Keratomileusis became the first operation by which
a piece of an organ was removed, modified, and re-
placed in its original position. A computer deter-
mined the degree of surgery necessary to compen-
sate for the defect in the eye. The surgeon numbed
the patient’s eye with drops before placing a suction
ring over the eye to secure it and maintain pressure.
The patient stared at a beam of light to keep the eye
still. Using a device called a microkeratome, the doc-
tor cut a thin layer of the cornea—about 30 percent
of its thickness—forming a flap and folding it back.
The laser reshaped the flawed corneal tissue, then
the flap was placed back over the eye and allowed to
heal without stitches over the next six to eight weeks.
About 98 percent of people who underwent LASIK
surgery subsequently enjoyed 20/40 vision or better.
The risk of a vision-threatening complication was
less than 1 percent. In the 1990’s, LASIK surgery was
expensive, with the cost dropping from $4,000 to
$2,000 per eye over the decade. Fees were not always
covered by insurance. The high cost was due to ex-
tensive training and expensive equipment.
Impact Myopia affected about 75 million Ameri-
cans by 2000. Many people reported that LASIK sur-
gery had changed their lives by giving them the abil-
ity to see clearly without corrective lenses.
Further Reading
Buratto, Lucio, and Stephen F. Brint.LASIK: Princi-
ples and Techniques.Thorofare, N.J.: SLACK, 1998.The Nineties in America LASIK surgery 503