Seeing clearly: Air Force helps Airmen correct their vision



by Becca Burylo
Air University Public Affairs


2/22/2013 - MAXWELL AIR FORCE BASE, Ala. -- By Rebecca Burylo
Air University Public Affairs

Lasers are in the business of helping Airmen see the clearest they can through corneal refractive surgeries, better known as LASIK and PRK, which can also help the Air Force mission.

The Air Force is the strongest proponent for its Airmen to have the surgery, and will even pay for the procedure.

Reducing an Airmen's need for corrective lenses will help with their performance of operational duties and the doctors at the Maxwell clinic are ready to walk them through each step, according to Staff Sgt. Andrew Rodriguez of the 42nd Medical Group Optometry Flight.

"We're making sure you're getting the best care that you can get," said Rodriguez at the last briefing Feb. 4. "I love sending people down to get their refractive surgery. It's just a good thing all around."

Briefings for the refractive procedures, given at the Maxwell medical clinic every first and third Monday of the month at 3 p.m., explain the differences between the two types of surgeries, and the requirements and disqualifications for each.

LASIK [Laser in-situ Keratomilieusis] and PRK [Photorefractive Keratectomy] are both completely elective procedures for Airmen, with each procedure harnessing a laser to reshape the eye's cornea, not the entire eye, said Rodriguez.

"Corrective refractive surgery does not change the shape of your eye," he said. "All we're changing is the window and pretty much the way your eye perceives light."

PRK sculpts the front layer of the cornea. It is a noninvasive procedure, which reduces the risk of infection. On the other hand, LASIK creates an entry point through the cornea much like a doorway, allowing the laser to sculpt inside.

The flap, or doorway, created on the cornea acts like a suction cup when put back in place. Capt. Lannie Calhoun, optometry flight commander, says that statistically, the results from either procedure are equal six months after the surgery.

"Both procedures are good," said Calhoun. "Every patient that is approved for the surgery has an opportunity to discuss the different surgery options with the ophthalmologis who will actually perform his or her surgery. That conversation between the patient and surgeon is critical, as there is no single answer that is right for every patient."

However, some of the deciding factors Airmen face when determining which surgery to have are the length of recovery and the severity of pain.

Staff Sgt. Melissa Hay, with Air University Television, is scheduled to have PRK surgery in April and is scared of the pain, but trusts the doctors at Maxwell.

"That part scares me, the pain part, but given the fact that I won't have to deal with contacts hurting my eyes or glasses in the rain, or not being able to wear sunglasses in the sun, will make it all work out," said Hay.

LASIK involves only seven days of recovery with little to no pain involved. PRK, on the other hand, has a much longer healing period resulting from the scars or haze formations that can form on the cornea. PRK patients must go through a strict regimen of steroid eye drops to prevent permanent scaring and pain medication for one to four months following the procedure.

"That's why you see LASIK more often in the civilian world, and that's why when you hear about eye corneal refractive surgery, the first thing you hear over in the civilian sector is LASIK," said Rodriguez. "It has a quick recovery period and patients don't deal with scars or haze formations, and they come off the table pretty much seeing as well as they're going to see, with slight improvements within seven days after the procedure."

Second Lt. Nathan Cosker, a Life Cycle program manager at Gunter, decided a quicker recovery worked best with his schedule and mission demands, thus choosing LASIK.

His surgery was over in five minutes last August, and Cosker is very pleased with his 20/20 vision.

"I'm very happy. The process wasn't difficult at all, and the clinic makes it straight forward, telling you what you need to do and all you need to know," Cosker said, adding that he owes it all to the Air Force. "I have the Air Force to thank for making it possible. It has helped me in my PT, marathons and outdoor activities that I like to do without having to worry about sensitivity of contacts during allergies or when I deploy."

Calhoun loves hearing such stories of how refractive surgery has helped Airmen worry less about things like gas mask inserts and glasses when deployed and encourages them to see if they are good candidates for the procedure.

"It's a 'game-changer' for so many people that have a need for a lot of vision correction," said Calhoun. "It's very satisfying to have a patient that previously needed glasses to be able to drive and see the alarm clock in the night without them," he said adding, "We love to talk about the CRS program and are happy to answer questions."

After the surgery for either procedure, patients should remain at their selected center for the first week to monitor the healing process. Mandatory follow-ups are scheduled for one, three, six and 12 months after the appointment.

Eligibility

· Applicants must be 21 years old or older.

· Must have had six months of consecutive active duty, one year for aviators and 180 days for Guard or Reserve.

· Airmen will not be able to deploy for six months after surgery.

· Eye prescription should be consistent.

· Cannot have a dry-eye condition.

· Cannot have previous corneal scarring.

· Cannot be diagnosed with an autoimmune disease such as glaucoma, multiple sclerosis, psoriasis, Graves' disease, AIDS/HIV or diabetes.

· Cannot be pregnant.

After attending the briefings, applicants will be added to an electronic waiting list based on priority and will be sent an email to schedule a screening to evaluate whether or not the patient is a good candidate for refractive surgery.

Clinical Screening

· Patients cannot wear soft contacts for 30 days or hard contacts for 90 days prior to the evaluation appointment. Wearing contacts will change the shape of the eye enough to give an inaccurate view of the cornea.

· Bring in a year-old prescription if using a civilian healthcare provider to check for stable refraction history.

· Bring in the three forms sent with the initial screening email completely filled out to the screening, including a signed Commander's Authorization, the USAF Refractive Surgery Application and the Managed Care Agreement.

· Dilation will only be used for aviators and in determining borderline cases.

· Retinal health will be evaluated.

· Allow 45 minutes for the appointment.

If the patient is accepted, then the application package is mailed to the chosen Refractive Surgery Center and they will contact the patient within the next two to four months for surgery dates and scheduling details.