Some Active Duty Troops Cleared for Laser Eye Surgery
By Staff Sgt. Kathleen T. Rhem, USA
American Forces Press Service
WASHINGTON, July 20, 2000 With only a few exceptions, active duty soldiers, sailors, airmen and Marines are allowed to have their vision corrected with laser eye surgery and not worry about it affecting their careers.
Service officials have been studying photorefractive keratectomy, or PRK, and laser in-situ keratomileusis, commonly called LASIK, the two most common procedures, almost since their outset and are convinced they're safe for military members in most career fields.
PRK involves correcting vision by using a laser to remove surface corneal tissue. In LASIK, the surgeon cuts a flap in the cornea, flips it aside, removes corneal tissue with a laser, and flips the corneal flap back into place.
Members do need to be evaluated by a medical board after receiving the now-rare radial keratotomy, RK, the first common vision-correction surgical procedure. RK involved shaping the cornea with spoke-like scalpel cuts that, service medical officials insisted, weakened the eye structure and put members at risk in military operating environments.
Service officials outlined the restrictions on their active duty members.
- Current Air Force rules prohibit aviators and "special duty" personnel -- pilots, flight surgeons and engineers, pararescue and air traffic controllers, for example -- from receiving any type of laser eye surgery, according to Dr. (Col.) Arleen Saenger, the service's chief of physical standards. Air Force officials, however, are coordinating a waiver policy that would allow aviation and special duty personnel, including limited numbers of pilots to obtain PRK -- but not LASIK. Saenger said the policy change approval is expected soon.
She said the Air Force doesn't prohibit other personnel refractive surgery. But DoD Health Affairs officials said both PRK and LASIK are elective surgery not covered by TRICARE. Airmen seeking either procedure must be on leave, and they must notify and be counseled by the TRICARE benefits adviser at their nearest military medical treatment facility within three days of surgery, Saenger added.
- Navy policy disqualifies its aviators from flying duty if they have either procedure, Capt. Charles Barker said. Barker is the director of aerospace medicine for the Navy's Bureau of Medicine and Surgery here.
"If they go out and get this on their own, don't tell anybody and get caught, they're not physically qualified and they would have to be reassigned to some other general duty to finish their obligation," he said.
Barker said Navy policy may be affected, however, by two ongoing studies into the effects of laser eye surgery on aviators. Navy pilots enrolled in these studies can receive a waiver to remain on flying status.
Navy SEALs and divers are allowed to receive PRK, but not LASIK. "LASIK continues to be disqualifying with no waiver recommended for SEALs and divers," he said.
Sailors and Marines are required to have their commander's approval before having either procedure done and they must be cleared by service medical personnel before they can return to duty, Barker said. Complete information concerning the Navy Department policy on corrective eye surgery is available on the Internet at http://navymedicine.med.navy.mil/PRK/refractive_surgery_information.htm.
- Army aviators will flunk their flight physicals if they have PRK and LASIK, but the Army is different from the other services in that it's providing PRK free to certain soldiers, said Army Dr. (Lt. Col.) Vernon Parmley, director of the Cornea Service at Madigan Army Medical Center, Fort Lewis, Wash.
Womack Army Medical Center at Fort Bragg, N.C., has been performing free PRK laser eye surgery on active duty soldiers since June 1. The highest priority there goes to Special Forces soldiers, Rangers and soldiers in some frequently deployed units.
Army medical officials say the service plans to offer the procedure at four more centers by mid-2001. More information on the Army policy concerning laser vision correction is available at http://www.armymedicine.army.mil/armymed/default2.htm.
Officials from all the services stressed the importance of research before having any elective procedure. "This is surgery on your eyes," said the Air Force's Saenger. All surgery carries inherent risks, she said, and that fact is unfortunately downplayed or ignored in PRK and LASIK ads.
"Don't rely on any one person, any one Web site, any one source to give you the entire story about the risks and the benefits," Saenger said. "People really, really need to make an informed decision. It's not like glasses or contacts that you can change if they're not quite right."