The U.S. Navy's Doctrine of Laser Eye Surgery

The New York Times reports that laser eye surgery — now performed on nearly a third of every new class of midshipmen — is transforming Naval careers. Navy doctors are performing these operations with "assembly-line efficiency," allowing older pilots to continue flying, and those who might otherwise have been disqualified to pursue flight school. The number of procedures has reportedly climbed from 50 to 349 over the past five years. The Navy uses a different procedure than that used on civilians — grinding the cornea rather than cutting a flap — out of fears that the flap could come loose in supersonic combat.

Grinding your eyeball?

[OverlordQ]

I've had glasses since I was 11 months old, and as much as I'd like to get rid of them, getting flaps cut or 'ground down' just dont sound very appealing to me.

Re:Grinding your eyeball?

[no_pets]

I agree. I mainly dislike wearing glasses when it's raining or if I begin to sweat. I clean my glasses nearly every day and it's a pain. But at the end of the day I know that I can see - with my glasses.

Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.

Let a military doc operate on my eye?

[winkydink]

Maybe if I was in danger of losing it. Or maybe they've improved a lot since I was in many moons ago. The commonly held belief back then was these docs (and dentists... don't get me going on this one...) were only in the military because they couldn't hack private practice. No suing for malpractice if you're a GI and the doc screws up.

Re:Grinding your eyeball?

[planetmn]

I agree. I mainly dislike wearing glasses when it's raining or if I begin to sweat. I clean my glasses nearly every day and it's a pain. But at the end of the day I know that I can see - with my glasses. Sure, eye surgery can solve these problems and it's not very likely that the surgery will "backfire". But that just is not a risk I would like to take with my eyesight.

Can't the same be said about every medical condition/procedure?

Sure, the remedies aren't going to be 100%, but if we waited for them to be perfect, we'd still have extremely short life expectancies.

-dave

Re:Grinding your eyeball?

[no_pets]

True. Nothing is 100%. Each person just has to weigh the pros/cons of each procedure. IMHO eye surgery in most cases is more like plastic surgery than a real medical procedure. It doesn't have to be done to correct eyesight.

Re:Grinding your eyeball?

[spicyjeff]

Sure, but some risks are bigger thatn others. And like the granparent post said, I too would rather keep wearing corrective lens (contacts in my case) rather than risk loosing site for life. Even if that risk is small. The potential loss is huge. If given such a horrible choice I would much rather loose appendages or other sensory organs/sensations than my vision.

Re:Grinding your eyeball?

[rwven]

You should look into blade-free intralasik. No cutting needed. I personally wouldnt want someone taking a knife to my eyes either.

How many eye doctors do this do themselves?

[Clueless Moron]

I have been to two different opthalmologists over the past few years, and both of them wear regular glasses. They don't even use contact lenses.

Their explanation in both cases was the same: we really don't know the long-term effects of PRK/LASIK/LASEK. It could have side effects (triggering glaucoma, etc) that would render you near blind in 30 years. Is it really worth that risk?

So I'm sticking with glasses. For one thing, I'm over 40 and while I'm still nearsighted, normal age-related presbyopia is setting in. I can deal with it by simply removing my glasses to look at things that are up close. If I had LASIK, I'd need to carry reading glasses with me all the time, so there's not much of a win.

Re:Let a military doc operate on my eye?

[Brooklynoid]

I'm not qualified to comment on the skills of Navy docs in general, but if I were going to get laser eye surgery, I'd feel pretty comfortable knowing that the doc who's going to be doing it has done literally thousands of that same procedure before, and has turned out results good enough for their patients to qualify as fighter pilots.

Just my $0.02

Re:Grinding your eyeball?

[bracher]

Laser eye surgery, from my perspective, amounts to _elective_ surgery on what I consider to be an irreplaceable part of my anatomy.

But maybe it's just me...

Re:Grinding your eyeball?

[spicyjeff]

Interesting point. That might get me to change my mind, any idea where to look for some good facts?

Re:Grinding your eyeball?

[Greyfox]

Oddly, when I was wearing contacts I'd wear 'em all day every day (Taking them out at night to sleep.) Then during one eye exam my doctor told me that my eyes weren't getting enough oxygen and that was causing an overabundance of blood vessels to grow in my eyes. He told me to cut back on my contact-lens wearing or bad things would happen. He was kind of vague on what kind of bad things, I assume my eyeballs would fall out of my head or something like that.

I had lasik a couple of years ago. Now here's the thing I can't understand about people who get lasik... You're taking a risk with your eyesight. You would think that you would take care to make sure you get a good surgeon. I did a lot of research on the internet, found a surgeon with an eyeball tracking laser and made sure he was doing the right tests and executing due dilligence prior to the surgery. I also dropped 2 grand an eyeball to have it done. Now the thing is, when you're doing something like this, why would anyone even consider "Bob's Discount Lasik -- Buy one Eye, Get one Free!" Or going to Thailand to have lasik done? Sure you might shop around on a car or a sofa, but when your body's involved the first point of consideration should NOT be the price of the procedure.

Anyway I did the research and decided the risk was worth it and now have perfect vision in one eye and better than perfect vision in the other. I'd do it again in a heartbeat. It was hardly uncomfortable at all, too -- I just had to take tylenol for a slight headache. I hear PRK is rather less comfortable and has a longer recovery period but I think I'd still have gone that route if I hadn't been able to have lasik for any reason.

Re:Let a military doc operate on my eye?

[Anonymous Coward]

I'm active-duty Air Force. I had the PRK surgery done several years ago at a major Air Force medical center. The doctors there, all active-duty, were very careful to explain the risks and benefits of the surgery, and also compared the different surgical techniques (PRK vs. RK vs LASIK, etc). They had kept very careful statistics on their success rate, and IIRC it was over 98% of the 2000+ eyeballs operated on that had achieved 20/40 or better. I was very happy with the treatment I received, and the follow-up care. I'm still very glad I had it done, and I'm glad it was PRK and not LASIK. Although the recovery time was longer and more uncomfortable with PRK vs LASIK, PRK has fewer possible complications (such as the flap being dislodged).

I can hardly remember what life was like having to wear contacts or glasses, and I'm glad I don't have to deal with that anymore... Although, there is a very good chance that I'll need reading glasses in about 10 years--that's a trade-off that I'm willing to take.

Re:Grinding your eyeball?

[GigG]

It doesn't have to be done to correct eyesight.

It does if you want to fly fighters which is what TFA is talking about.

Re:Grinding your eyeball?

[Seraphim1982]

You might think differently if you vision was so bad that you were legally blind.

Re:PRK Experience

[asuffield]

Next up was a device that measured my perscription. I had to stare at
a little picture while it zoomed in and out of focus. Apparently this
determines my exact perscription, none of that "Is this better, or that"
lens swapping. I wonder why eye doctors don't use this all the time.

Well, there's a number of reasons... the machines are expensive, and they're even more expensive for really accurate models. They aren't perfect, and sometimes get it wrong (but that's usually pretty obvious when the lenses you get just don't work for you, and a second check on a different machine should catch this).

But the #1 reason? If you check somebody's eyes in 30 seconds with a machine, instead of spending 10 minutes doing it by hand, many people don't think you're doing it properly, or don't think they're getting "their money's worth". It's utterly stupid, but so are the majority of the people who go to an optician - remember, it's the same people that TV is made for.

Re:Grinding your eyeball?

[F_Scentura]

"It doesn't have to be done to correct eyesight."

Permanently, yes it does.

PRK done on civilians!

[billnapier]

Due to thin cornea's, I opted to have PRK done on my earlier this year (rather than LASIK). I have no plans on doing supersonic flight thought, and am VERY VERY happy with the results.

The quick pro/con list of PRK vs. LASIK:

pro PRK:
no cutting of the cornea

con PRK:
can be more painful
longer healing time

The results of both procedures are exactly the same.

Re:Grinding your eyeball?

[drinkypoo]

IMHO eye surgery in most cases is more like plastic surgery than a real medical procedure. It doesn't have to be done to correct eyesight.

First of all, I think the word you are looking for is not "real" but "necessary". Plastic surgery is a "real" medical procedure by any reasonable standard.

Second of all, what are the other options for correcting eyesight? Glasses are a temporary fix, they're not correcting jack shit. Sure, there's exercises you can do to attempt to improve your vision, but by the time it's worth doing laser surgery, they usually don't help.

Re:Grinding your eyeball?

[Anonymous Coward]

Wow, I'd expect a /. user to be less suseptible to marketing. MORE EXPENSIVE != GUARANTEED BETTER Christ, go buy a $1200 wallet while you're at it.

'Bob's discount lasik' probably uses the same exact equipment as 'Tom's Platnium+ super special lasik'. They both passed the same boards, have the same degree, and several years experience.

Bob spends about $50/month on advertizing (i.e. business cards). Tom spends $50,000/month on radio/tv commercials, full-page newspaper adds, and the like. Bob can charge less than $1000 for both eyes and has plenty of clients. He does as many eyes as he has time for and can pay attention each client. Tom has to charge $2000 per eye and the first 25 a month just pay for advertizing. He runs a factory that pushes clients in and out as fast as possible. Nurses do 90% of your exams which he quickly 'verifys' before your exam.

Granted, I wouldn't go to a $50 special with a doctor just out of med school using left-over bayonets from WW2 as scalpels. That said, I'd much rather go see bob, save a huge chunk of cash, and get personalized attention than hop on an assembly line and pay for someone's advertizing and ferrari.

For those STILL spooked by laser eye surgery...get over it. Equating it to unnecessary plastic surgery shows your ignorance of the topic. It's got much more in common with reconstructive surgery - Should a 16 year old child with a bad knee live with wearing a knee-bracek for the rest of his/her life or accept the risks of surgery to correct the problem? It can make a major change to ones' quality of life.

I challenge ANYONE to show ACTUAL EVIDENCE of a modern LASIK/PRK/LASEK proceedure performed by a qualified/certified MD CAUSING blindness. SH!T, don't cross the street because a car might hit you. It's amazing how some pathetic people live in fear of everything simply because they fall prey to desperate attempts at advertizing.

Re:Grinding your eyeball?

[Anonymous Coward]

Partly because they generally don't provide correction to peripheral vision, partly because air masks would have to be designed to seal around them, mostly because extreme G-forces easily dislodge them (no matter how tight a strap you have).