by Gary
Boyle
Hilltop
Times Staff
(Hilltop Times is a newsletter published by the Hill Air
Force Base’s Ogden Air Logistics Center)
December 11, 2003
The Air Force has approved the start
of an expanded program for corneal refractive surgery that will include
Laser-Assisted In Situ Keratomileusis, better known as LASIK, for qualified
airmen. The procedure joins the military’s preferred eye surgery
Photorefractive Keratectomy, PRK, in enhancing warfighter vision.
Five Air Force centers are
performing PRK while Wilford Hall Medical Center and the Air Force Academy are
performing both surgeries.
The military has a better success
rate than private practitioners, but it also has strict parameters personnel
must fill to be eligible for the procedure and Hill’s optometry center at the
Base Clinic is the place to go for detailed information.
The military is performing more
Photorefractive Keratectomy surgeries than the better-known LASIK. The
difference between the two is with PRK the outer layer of tissue is removed
from the eye before the laser surgery is done and then grows back and takes a
patient about three to four days to recover. The tissue is no thicker
than a few strands of human hair.
With LASIK surgery a flap is cut in
the tissue before the laser surgery and then placed back. The time to
recover is about one day and the patient will notice an improvement in vision
within a few hours after the surgery. The problem with LASIK is the flap
may cause complications with impact or under intense g-forces, according to
Hill AFB clinic optometrist Maj. (Dr.) Court Wilkins.
Airmen electing to have LASIK
performed should be aware of potential complications associated with the
corneal flap that are not associated with PRK. Under current policy LASIK
surgery makes airmen ineligible to train for most aviation fields.
“There are general concerns with
corneal-flap-related complications of LASIK that go beyond routine clinical
issues that are specific to the aviation and operational environment,” said
Rhodes. “There is no corneal flap created with PRK. For this
reason, PRK remains the preferred procedure, and expectations are that it will
continue to be performed in much greater numbers.”
Because of the expected high demand
for the procedure, patients are assigned an operational priority based on
mission requirement. The choice between LASIK and PRK depends on the
assigned center’s capability, the opinion of the surgeon and patient
eligibility based on Air Force specialty code. Depending on demand the
waiting list to have the operation done by an Air Force center for a
non-aviator is more than a year, while an aviator’s wait time is shorter.
Hill airmen wanting to use the Air
Force center will likely go to the Air Force Academy in Colorado. They
can expect to spend two weeks and provide for room and board. An airman
must take personal leave or at the discretion of the commander permissive TDY
has been approved by the Air Force.
Airmen who don’t want to wait can
elect to have the surgery performed by a private practitioner, but should consider
the Air Force guidelines before choosing between LASIK and PRK.
“There’ve been pilots who have lost
their wings because they went to a private facility and had LASIK surgery done,
which is not approved for aviators,” said Wilkins.
“Do your research. You’re
paying for a delicate procedure and also you’re buying the support after the
surgery you may need. There are billboards that advertise cheap surgery,
but for a year’s worth of follow ups and enhancements expect to pay between $2,000
and $2,500,” said Wilkins. “TRICARE does not pay for it, but we can help
finding the right place for you.”
The surgery, though usually
successful, is not fool proof. Patients may experience streaks and halos
of light. About 20-percent of those who have the surgery will still
require contact lenses or eyeglasses for 20/20 vision. There is a slight chance
pilots who have PRK will become disqualified for flight duties and there is a
chance for decrease in night vision and the ability to detect camouflaged
targets.
“We want airmen to come to us first.
We can help with pre and post-operative procedures and educate on how to
access the military surgical centers,” said Wilkins. “The surgical centers
have been good at working with individual needs. Most airmen at Hill will go to
the Air Force Academy but there are those who choose to have this operation
done at a different center.”