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The U.S. Navy's Doctrine of Laser Eye Surgery 547

Posted by timothy from the woodchipper-surgery dept.
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.
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The U.S. Navy's Doctrine of Laser Eye Surgery More

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

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  • Grinding your eyeball? (Score:5, Insightful)

    by OverlordQ ( 264228 ) on Tuesday June 20, 2006 @12:03PM (#15569869) Journal
    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? (Score:5, Insightful)

      by no_pets ( 881013 ) on Tuesday June 20, 2006 @12:07PM (#15569902)
      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.

      • Re:Grinding your eyeball? (Score:5, Insightful)

        by planetmn ( 724378 ) on Tuesday June 20, 2006 @12:14PM (#15569980)
        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? (Score:5, Insightful)

          by no_pets ( 881013 ) on Tuesday June 20, 2006 @12:20PM (#15570035)
          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? (Score:5, Insightful)

            by GigG ( 887839 ) on Tuesday June 20, 2006 @02:37PM (#15571153)
            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.
          • "It doesn't have to be done to correct eyesight."

            Permanently, yes it does.

            • Re:Grinding your eyeball? (Score:4, Interesting)

              by GWTPict ( 749514 ) on Tuesday June 20, 2006 @05:59PM (#15572631)
              Permanent it ain't, I've worn glasses to correct short sightedness since I was 11 years old and yes, I could have had laser surgery at some point to correct it, I never bothered because wearing glasses has never bothered me and I quite like being able to make the world go fuzzy when it's all getting a bit to much. Now at the age of 43 my prescription requires varifocals to correct my near point as the elasticity/flexibility of the muscles that change the shape of my lens deteriorates. As you get older your sight changes, possibly that could be corrected with more laser surgery but it is not in of itself a permanent fix. Anyway it's night time here and it's raining so I'm going to take my glasses off and look at the pretty patterns on the street lights :>)

          • 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 t

        • Re:Grinding your eyeball? (Score:5, Insightful)

          by spicyjeff ( 6305 ) on Tuesday June 20, 2006 @12:24PM (#15570093) Homepage
          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? (Score:5, Funny)

            by hoggoth ( 414195 ) on Tuesday June 20, 2006 @12:27PM (#15570132) Journal
            > rather than risk loosing site for life
            > I would much rather loose appendages or other sensory organs

            It looks like it's too late to save your spelling organ.

          • Re:Grinding your eyeball? (Score:4, Informative)

            by MindStalker ( 22827 ) <mindstalker@@@gmail...com> on Tuesday June 20, 2006 @01:01PM (#15570389) Journal
            I too would rather keep wearing corrective lens (contacts in my case) rather than risk loosing site for life.

            You do realize that statistically over the course of your life contacts are a greater risk to your eyes than one quick surgery.

          • Re:Grinding your eyeball? (Score:5, Insightful)

            by Greyfox ( 87712 ) on Tuesday June 20, 2006 @01:30PM (#15570620) Homepage Journal
            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.

        • 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? (Score:5, Interesting)

        by swillden ( 191260 ) * <shawn-ds@willden.org> on Tuesday June 20, 2006 @12:26PM (#15570110) Journal

        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.

        Like lots of things, I think it's a risk/reward question. In my case, I wear glasses and will continue to wear glasses, but my vision isn't that bad so the reward I'd get from eye surgery isn't all that great. The glasses sharpen my vision and make it easier for me to read road signs, but I can actually get along just find without them.

        My wife, on the other hand, was blind as a bat without her glasses, to the point that she had to carefully place her glasses in the same place next to the bed each evening, because she had to find them by touch in the morning. She could not see them. She got Lasik about three years ago, and it has significantly improved her life. Before the surgery, for example, she didn't dare participate in any sort of water sports because losing her contacts or glasses would leave her completely blind. Now she SCUBA dives and I expect to get her up on water skis this summer. Even more important is the sense of freedom she has, being able to see without assistance. After the surgery, her sight was 20/20, but has gradually declined to where she is contemplating getting glasses again to sharpen her vision a bit. She could have the surgery re-done (for free, even, since a followup was included in the original price) instead of getting glasses, but it's no longer worth the pain or the risk.

        I know others with similar stories, and I can definitely see how someone who'd like to fly military jets would perceive the risk/reward tradeoff as a good deal. Heck, I'd get the surgery if it meant someone would let me fly an F-14.

      • Re:Grinding your eyeball? (Score:4, Interesting)

        by COMON$ ( 806135 ) on Tuesday June 20, 2006 @12:56PM (#15570346) Journal
        I had PRK done earlier this year. I had been wearing glasses since I was very young, like 5-6 years old. I was an athlete and contacts just didnt cut it in contact sports, and glasses were a nuisance but I lived with it all through my college sport years. Now I am without either and as much as RK surgery sucked (the bandages dried to my eyes 2 days after the surgery). I would not go back. I may have to wear glasses again when I am 45 but to have 20 years or so being able to see my wife in the morning, not having to worry about cuts in my contacts, or having my glasses break at inopportune times, is all very much worth the 3K to do it.

      • Re:Grinding your eyeball? (Score:3, Interesting)

        by ajs ( 35943 )
        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.
        I have to wonder how the chances compare... is it more likely that in 30 years of wearing glasses, something will go wrong that hurts you (you poke yourself in the eye with them or some other problem) or that you'll suffer a problem during surgery? It's probably worth researching.

      • Re:Grinding your eyeball? (Score:4, Informative)

        by Anonymous Coward on Tuesday June 20, 2006 @01:17PM (#15570501)
        As a 37y/o that had been wearing glasses and contacts since I was 6, I had many of the same concerns listed in this thread. But this past February I took the plunge and had Intralase Lasik. It is the best money I have ever spent. The worst part of the procedure is the Intralase that creates the corneal flap. The actual Lasik part was really fast, only a couple of seconds per eye. You just have to be very careful for the first couple of weeks after the procedure to give your flaps time to heal. I just had my 3 month check up, and I was able to see 20/10 - 2, which means I could get 2 of the letters on the 20/10 line. This is utterly amazing to me, since my eyesight was so poor.

        It is a big step to take though, and I can truly understand the uneasiness some feel about this procedure, but I am a complete convert now. It is the best money I have ever spent. If you live in Houston Tx I would seriously go the Mann Eye institute and at least take advantage of the free evaluation. Hell get evaluated by 2 or 3 doctors.

      • But at the end of the day I know that I can see - with my glasses.

        At the end of the day, people with laser surgery can basically see. Some have problems with glare, and some develop vision problems that can't be corrected even with glasses, but the procedure basically works for most people despite the risks.

        That's at the end of the day. How about at the end of the decade, or of your lifetime, though? This thing has only been done for a short while now, and the longitudinal studies aren't in, by definit

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

    • Re:Grinding your eyeball? (Score:5, Informative)

      by UttBuggly ( 871776 ) on Tuesday June 20, 2006 @01:12PM (#15570455)
      Well boys and girls, I had my "eyes done" at age 40, which was 10 years ago. I had terrible myopia and astigmatism so bad, I couldn't wear contacts of any kind.

      I was in the Air Force in the 70's and tried to fly; no dice with 20/400 vision.

      It was never vanity, but practical reasons that caused me to take a chance on eye surgery. I've always been involved in sports and martial arts. I've had a zillion cuts and bruises on my face (nose especially) from that. Then in 1995, I started fighting full contact with some serious folks. Now, I always fought WITHOUT glasses because I only had to see the shape in front of me, right?

      Nope. A circular technique like a roundkick didn't "show up" in my field of vision until too late to block or duck effectively. After two concussions and some broken bones, I went under the knife on both eyes. Today, I'm still 20/20 in both eyes and love it.

      I retired from fighting about a year ago but my last fight was in a small ring with 3 opponents at least 10 years younger than me. We went about 20 minutes non-stop and as one of them commented later "we never got a clean shot in even once!"

      Yeah...I'm real unhappy with eye surgery...NOT!

      Seriously, do a lot of research and shopping for a good doctor. Check with his patients who are 1, 2, 5 and 10 years out from their work. See what they say. Then, do it!

      Hell, it was worth it not to have permanent furrows on either side of my nose anymore from the weight of the coke bottle bottom glasses I had to wear from age 5 on. :o)

  • the flap? (Score:5, Funny)

    by oni ( 41625 ) on Tuesday June 20, 2006 @12:03PM (#15569871) Homepage
    the flap could come loose in supersonic combat.

    there's a circumsicion joke there somewhere

  • Let's get it out of the way. (Score:3, Funny)

    by Tackhead ( 54550 ) on Tuesday June 20, 2006 @12:03PM (#15569874)
    > 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.

    "Plenty to see here. Cleared for takeoff."

  • Dammit (Score:5, Funny)

    by Anonymous Coward on Tuesday June 20, 2006 @12:05PM (#15569890)
    I thought this article was about laser-eye surgery, as opposed to laser eye surgery. Meaning I could FINALLY get surgery allowing me to shoot lasers out of my eyes. Like Superman. I've never been so disappointed in my life.

  • It's certainly a better method..... (Score:3, Interesting)

    by i_want_you_to_throw_ ( 559379 ) on Tuesday June 20, 2006 @12:07PM (#15569907) Journal
    I have known people who were suicidal after having Lasik because they had it done at a "399.00 per eye" where the point is to get people in and out as fast as possible.

    The problem with Lasik is that the burn area is only so big and some people's pupils dilate past that point resulting in all kinds of weird effects on the vision. Grinding would seem to allow much more control over the treatment area.

    If you're going to get conventional Lasik here are some things to remember....
    1. It IS surgery contrary to how "routine" Lasik places try to pass it off
    2. Research your doctor doing the procedure
    3. If you're lucky your doc possesses a cornea fellowship from Emory University

  • Misleading summary (Score:4, Informative)

    by Mindwarp ( 15738 ) on Tuesday June 20, 2006 @12:08PM (#15569921) Homepage Journal
    I think the phrase 'ground down' used in the summary is a little misleading. It's not an abrasive process which is used to reshape the cornea; rather a laser is used to ablate it.

    Not that the word 'ablate' is any more paletable than 'grind' when it's coupled with the word 'cornea.'

  • Full Article Text (Score:5, Informative)

    by rehtonAesoohC ( 954490 ) on Tuesday June 20, 2006 @12:09PM (#15569928) Journal
    BETHESDA, Md., June 17 -- Almost every Thursday during the academic year, a bus carrying a dozen or so Naval Academy midshipmen leaves Annapolis for the 45-minute drive to Bethesda, where Navy doctors perform laser eye surgery on them, one after another, with assembly-line efficiency.

    Nearly a third of every 1,000-member Naval Academy class now undergoes the procedure, part of a booming trend among military personnel with poor vision. Unlike in the civilian world, where eye surgery is still largely done for convenience or vanity, the procedure's popularity in the armed forces is transforming career choices and daily life in subtle but far-reaching ways.

    Aging fighter pilots can now remain in the cockpit longer, reducing annual recruiting needs. And recruits whose bad vision once would have disqualified them from the special forces are now eligible, making the competition for these coveted slots even tougher.

    But the surgery is also causing the military some unexpected difficulties. By shrinking the pool of people who used to be routinely available for jobs that do not require perfect eyesight, it has made it harder to fill some of those assignments with top-notch personnel, officers say.

    When Ensign Michael Shaughnessy had the surgery in his junior year at the Naval Academy, his new 20-20 vision qualified him for flight school. And that is where he decided to go after graduating last month ranked in the top 10 percent of his class, rather than pursuing a career as a submarine officer.

    "The cramped environment in submarines is something that turned me off," Ensign Shaughnessy, 22, said.

    For generations, Academy graduates with high grades and bad eyes were funneled into the submarine service. But in the five years since the Naval Academy began offering free eye surgery to all midshipmen, it has missed its annual quota for supplying the Navy with submarine officers every year.

    Officers involved say the failure to meet the quota is due to many factors, including the perception that submarines no longer play as vital a national security role as they once did. But the availability of eye surgery to any midshipman who wants it is also routinely cited.

    "Some of the guys with glasses who would have gone to submarines or become navigators are getting the chance to do something they'd rather do, and the communities that are losing the people are not as happy about it as the aviation community, which is gaining better candidates," said Cmdr. Joseph Pasternak, the ophthalmologist who oversees the program at the National Naval Medical Center in Bethesda.

    In the Naval Academy's class of 2006, 349 of the 993 midshipmen had the surgery, up from 50 five years ago, according to Naval Academy records. Fewer than 30 percent of the academy students whose eyes qualify for the surgery choose not to get it, and the number of holdouts is dropping every year, Commander Pasternak said.

    Last week, a little after 10:40 a.m., Colin Carroll, a 21-year-old midshipman from Olney, Md., put anesthetic drops in his eyes and lay down under the laser as Capt. Kerry Hunt, a Navy doctor, and two assistants prepared to begin. "We're locking the laser on now," Captain Hunt told him.

    Midshipman Carroll had originally hoped to enter flight school but discovered not only that his eyes were not good enough, but also that he was prone to kidney stones, ruling him out of aviation entirely. He said he was "resigned" to entering the Marine Corps or becoming an officer on a surface ship, neither an assignment requiring perfect vision.

    But he decided to get the surgery anyway.

    By 10:49, both eyes were done, though extremely bloodshot, and Mr. Carroll walked out wearing sunglasses, declaring he could already see better.

    The procedure used by the Navy, photorefractive keratectomy, or PRK, is different from the one used on most civilians. That approach, known as laser-in situ keratomileusis, or Lasik, requires cutting a flap in the surfa

  • PRK (Score:5, Informative)

    by SuperSanta ( 843034 ) on Tuesday June 20, 2006 @12:10PM (#15569934) Journal
    The method the Navy uses has been available to civilians for years now. I should know - I had it. In LASIK SURGERY the potential for the flap to come apart exists because only the outer edge of where the cut is made heals. You recover in 3 - 5 days instead of 5 - 8 with PRK. But with PRK you don't have the heebie geebie factor of eye flaps busting loose. In fact most eye doctors will recommend PRK to those under 30 with any kind of an active lifestyle for sports, scuba diving, etc.

    While taking a week or more off work is tough for some - YOU'RE PUTTING FRIKKIN' LASERS IN YOUR EYES in either way. Why not take the more permanent / durable approach? Don't chose 'Hi Dr. Nick' budget solution either. That's just stupid.

    • Re:PRK (Score:3, Interesting)

      by thatguywhoiam ( 524290 )
      You recover in 3 - 5 days instead of 5 - 8 with PRK. But with PRK you don't have the heebie geebie factor of eye flaps busting loose. In fact most eye doctors will recommend PRK to those under 30 with any kind of an active lifestyle for sports, scuba diving, etc.

      That's not quite accurate. "Most" doctors will recommend PRK for those with thin corneas. You need a certain amount or corneal tissue available to be ablated (12 microns per diopter of correction), that leaves your eyes with enough structural inte

  • Figuratively and now literally (Score:3, Funny)

    by ciaohound ( 118419 ) on Tuesday June 20, 2006 @12:10PM (#15569935)
    I had heard that the Naval Academy was a grind...

  • They've been doing this in the Army for a while... (Score:5, Interesting)

    by cavtroop ( 859432 ) on Tuesday June 20, 2006 @12:12PM (#15569961)
    ...also.

    I got out quite a few years ago, before this was possible. My cousin however is still in, and he got the surgery done, for free. They offer it to everyone, and encourage you to do it. It makes all aspects of being a soldier - particularly an infantryman, much easier. Now you can wear off the shelf eye protection, no longer are gas masks a pain in the ass to put on, nightvision goggle, scopes, sights in a tank, are all easier to use.

    I think it's a great idea, myself.

  • Aging pilots (Score:5, Funny)

    by Rob T Firefly ( 844560 ) on Tuesday June 20, 2006 @12:16PM (#15570000) Homepage Journal
    Aging fighter pilots can now remain in the cockpit longer, reducing annual recruiting needs.
    Is this really that good an idea? My late grandmother, whose cruising speed topped off at around 25 MPH, once had a blinker light going for three whole Presidential administrations.

  • PRK Experience (Score:5, Informative)

    by Icepick_ ( 25751 ) <icepick@neCOWtfa ... minus herbivore> on Tuesday June 20, 2006 @12:17PM (#15570014) Homepage
    I had PRK done in Jan-05, and have been extrodinarily happy with the results.

    The only drawback was the day of "oh-my-god-what-have-I-done-get-these-icepicks-out -of-my-eyes" pain, and 3 days of "damn my eyes itch" iritation. Not for the faint of heart.

    Best money I ever spent, and I'd do it again in a heartbeat.

    • Re:PRK Experience (Score:5, Interesting)

      by Icepick_ ( 25751 ) <icepick@neCOWtfa ... minus herbivore> on Tuesday June 20, 2006 @12:23PM (#15570078) Homepage
      Followup to my own post. Here's a copy of my journals regarding my PRK experience:

      Exam notes:

      It was intresting. I had filled out the eye history sheet before I went
      in. They gave me a quick eye exam, but it wasn't like a normal one.
      First up was the typical Big E projected on the wall (no glasses!)
      "Nope, can't see it."

      Next up they took two pictures of each eye. It was a weird device, it
      was cone shapped, and I was looking into the big end of it. The inside
      was black, with many concentric circles of purple light, with a lens at
      the center. It made a topographical map of my corneas.

      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.

      Last of the inital measurements was another corenal mapper. Nothing to
      see, just a red light.

      Then I got a 10 minute vides summerizing LASIK. I knew all that stuff
      already from my research.

      Then I got to speak with the doctor. She did a few more measurements,
      including measuring the thickness of my corenas. Then we got down to
      the nitty gritty.

      I am NOT a good canidate for LASIK. The corena mappings reveal that
      they're buldging on the lower sides, kinda pear shapped. LASIK can be
      done, but by pealing back the flap, my corenas loose some of their long
      term strength, and I risk having them thin so much I may need a corena
      transplant in the years to come.

      However....I am an exceptional canidate for PRK, which is basicly LASIK,
      but with no flap, they just burn off the extra portions of the cornea.
      The recovery time is a bit more involved, and would likely be unable to do
      much of anything for a couple of days. I'd have to wear contacts as
      bandages while the areas where tissue was removed healed.

      Lots of questions with the doctor, but generally very optimistic about
      my final result being 20/40 or better. Like 95%+

      Then I was off to the office manager for the bottom line. $3700, for
      both eyes, all the pre and post care (7 appointments!), and any
      additional corrections for life. This about what I expected. And
      that's with 15% off from my insurance. I asked, normally they'd give a
      cash discount, but I can't combine it with my insurance. Then she gave
      me several consent forms and whatnot to review.

      4 hours post op:

      Well, I did it, and I'm not blind.

      It went very smoothly. Arrived, filled out a couple (more) consent forms, one last cornea mapping, and had a last minute chat with the doc. Got a perscription for some vicoden, and got my final post-op instructions. Paid the nice lady, and she gave me some Advil and a valium. Back to the waiting room for 10 minutes.

      The proceedure itself I can't really describe, as most of the time I was staring at a bright light 6" from my face. But, they gave me a stylish hair net, and ploped me in a dentist like chair. Leaned me back, and it slid me under the light/laser/camera.

      They gave me a half dozen eye drops in each eye and let me sit for a few minutes. I know one of them was an anastetic, hence the wait. They put a plastic shield over my left eye, and taped it in place. Then they tapped my eyelashs/eyelids open on the right eye. They put in the thingy that holds my eye open, which wasn't as uncomfortable as I thought it would be. Few more drops, and then they (according to C) put a little white disk over my cornea. I couldn't see anything, but after they lifted it, I could see the q-tip removing the outer layer of my cornea. Then, he used what looked to be a ice scrapper, I swear. Couple more drops, and then "Don't move, stare at the light" Then they fired up the laser, it made a clicking noise for about 40 seconds. The light went from really blurry to mostly blury, and then they popped in a "bandage" contact, and removed the thingy and left ey

      • Re:PRK Experience (Score:3, Interesting)

        by pherthyl ( 445706 )
        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.

        My optometrist has one and uses it but says it is not nearly as accurate as a manual exam with the lenses. It's just there to give him a rough estimate as a starting point, but it tends to overprescribe.

        • Re:PRK Experience (Score:3, Interesting)

          by moosesocks ( 264553 )
          My doc used to be the same way, but purchased a new one a year or two ago.

          The reason more docs don't have them? They're horrendously expensive (up to $50,000)

      • Re:PRK Experience (Score:3, Insightful)

        by asuffield ( 111848 )
        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 ju
      • >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.

        Everyone else is commenting on this and I thought I would, too.
        Most lens prescriptions consist of two parts: how many diopters of spherical correction you need for an eye, and a modification of that correction to account for astigmatism, which consists of a 2-D curve, a cylinder, added to the existing spherical correction. So you have a sphere of a

  • Join the Navy... (Score:3, Funny)

    by Lazbien ( 788979 ) on Tuesday June 20, 2006 @12:19PM (#15570023)
    I'm sure there's a joke in here somewhere...

    Join The Navy, See The World, etc

  • This is why... (Score:3, Funny)

    by Red Flayer ( 890720 ) on Tuesday June 20, 2006 @12:22PM (#15570060) Journal
    the Navy grinds instead of cutting a flap.

    (carrier landing).

    Altitude?
    - 1500 feet, sir.
    Gear?
    -Yes, sir.
    Flaps?
    - Open, Sir. What the hell? Everything's gone blurry and dark!!!
    Not those flaps, Lieutenant!

    (Crash... Blammm... splash splash of bits falling into the ocean).

    You see, there's a reason they grind instead of do anything involving flaps, and there's also a reason I'm not employed writing comedy dialogue.

  • PRK is most popular in Europe (Score:5, Interesting)

    by xutopia ( 469129 ) on Tuesday June 20, 2006 @12:29PM (#15570149) Homepage
    There are less side effects and the results are almost always better with PRK. It also is easier to do touch ups as needed. The reason why it isn't as popular in the states is that it requires people to take a few days off so their eyes recover. I could afford a week off in countries where you can get more than 2 weeks of vacation. ;-P Brought to you by the Vacation for everyone lobby.

  • Some subjective facts (Score:3, Informative)

    by Okian Warrior ( 537106 ) on Tuesday June 20, 2006 @12:30PM (#15570155) Homepage Journal
    I have actually had this (civillian) type of surgery.

    The "flap" is a thin, transparent layer over the cornea which is peeled back to allow the laser to shape the cornea, then it is placed back over the cornea and it heals. Older surgeries used to discard the flap entirely, but a crescent heals faster and with less discomfort.

    In my case the flap was discarded, it grew back with no problem. There was discomfort for the first week or so.

    I was awake during the entire process. They gave me a mild sedative but I don't really think it was necessary - there was nothing particularly exciting about it. The eye was anesthetized, of course, and this was tested before the procedure began. I was using the eye up to and during the surgery, at which point it was bandaged over.

    The actual laser part involved looking at a particular spot while the doc counted up some numbers like he was zeroing in on some chosen value. That's all there was: just look at some spot for about a minuts and it's done. No laser (visibly), no sound, no feeling, no buzzing or cutting or anything like that.

    The anesthesia wears off a couple of hours later, and the eye hurts like it has a bad foreign object in it, but it the pain was periodic and not excruciating. It didn't prevent me from working on the computer.

    There's nothing particularly exciting or scary about the procedure, and when it's all over you get to see clearly without glasses.

  • Long Term Effects of Lasik (Score:5, Interesting)

    by Don853 ( 978535 ) on Tuesday June 20, 2006 @12:33PM (#15570179)
    My parents are both MDs, so I always go to them with medical questions before paying anyone for advice.
    Last time I asked (I'm around -4.5 in both eyes), they were worried about the long terms of removing part of the lens in either eye. Apparently, part of the lens is also removed as a treatment for cataracts, and they had some worry that
    a) Laser eye surgery could remove enough of the lens to make cataract treatment later in life difficult or impossible, and, also
    b) There weren't any large scale long term (20+ yrs) studies on the rusults of the surgery.

    As I said, this is secondhand... perhaps if there's a MD or a Optometrist on these boards they could comfirm/deny/just explain better?
    • b) There weren't any large scale long term (20+ yrs) studies on the rusults of the surgery.

      Your parents are being very cautions, but they seem a little out of the loop as far as refractive surgery goes. There are, in fact, 20 year studies on the first PRK patients (and yes, the first guy can still see fine). LASIK is newer, 1991 I think, and so there are 15-year studies for that.

      As far as cataract surgery and such goes, you can have the docs measure your eye with a sonic sensor that measures corneal th

    • I'm 41. I had lasik surgery 3 years ago. At the time I decided that I'd lived enough of my life tied to glasses and contacts, and I wasn't going to win any beauty contests anytime soon. I trusted the procedure and the doctor enough to believe that nothing overly bad would happen. Worst case, I'd still be wearing glasses afterwards.

      As it turns out, I have perfect vision in my right eye and near perfect in my left. It's certainly disconcerting to have someone peeling your eye, burning part of the front o

  • How many eye doctors do this do themselves? (Score:5, Insightful)

    by Clueless Moron ( 548336 ) on Tuesday June 20, 2006 @12:37PM (#15570205)
    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.

  • out of fears that the flap could come loose in supersonic combat.

    Actually, LASIK concerns relate to high-g combat which is mostly subsonic. That's where pilots experience the highest inertial forces which could (theoretically) tear open a LASIK-cut cornea and eyeball. For every aircraft the optimum (quickest turn rate) turning speed is subsonic, and the ability to change the aircraft's attitude is paramount in tactical engagements.

  • Considering (Score:3, Interesting)

    by dubmun ( 891874 ) on Tuesday June 20, 2006 @01:25PM (#15570578) Homepage Journal
    I have been thinking about getting the Lasik for a long time. It seem to me that the risk versus reward is low in the short term. But we don't know what the long term effects of the surgery are... By long term I mean the possibility of being more suseptible to eye disease and disorders that are more common in later life.

    My mother had radial keritotomy (sp?) 15-20 years ago. My understanding of the procedure is that it is the equivalant of Lasik but using a blade to make the incisions instead of laser. My point is that she is in her mid sixties now and has developed glaucoma and will be forced to take eye drops every few hours and have regular checkups to keep it under control for the rest of her life. She has been told that her eye surgery may have put her in an elevated risk group for glaucoma, but not until now.

    Until I hear of more long term studies on the effects of Lasik... I think I'll wait.

  • Correcting some innacuracies. (Score:5, Informative)

    by guidryp ( 702488 ) on Tuesday June 20, 2006 @01:48PM (#15570765)
    The Navy is doing PRK. This was the first procedure done widely on civilians. Lasik was introduced later. The primary Lasik advantage is the patients have usable vision sooner and are pain free sooner. PRK is the better treatment, but in our quick fix society, Lasik is more popular. It is also pushed by many docs as there is less negative feedback from customers, less followups during the shorter initial healing cycle.

    Lasik, cuts a flap into the stroma, this is not the same flap that is removed for PRK as some folks have been characterizing. Alarmingly this flap never full seems to heal. It has been lifted YEARS after the original surgery. Lasik permanently weakens the cornea.

    PRK is essentially moving or removing the epithelium. A thin surface layer that will grow back, not the deeper flap cut in the above. Variant (LASEK or epi-Lasik) attempt to preseve the epithelial layer and use it as a sort of bandage during healing. This helps speed the healing and lower pain, but it is still not as good as traditional Lasik.

    Bottom Line:
    PRK and variants, better/slower/more painful. Laskik has more issues/complications, but is more comfortable/faster.

    The navy is making the right choice here.

  • PRK rocks! (Score:3, Interesting)

    by naChoZ ( 61273 ) on Tuesday June 20, 2006 @02:24PM (#15571036) Homepage Journal

    Not...

    I had it a couple years ago. I reposted my blog entry afterwards here in my slashdot journal [slashdot.org].

    Excerpt:

    She took her time. A swipe swipe here, a swipe swipe there, here a swipe, there a swipe... After she satisfactorily buffed away the covering of my eyeball, she used an actual broom to sweep away the leftover shit in my eye. I know this because I heard her say the word "broom" before she used it. There were other tools used. Again I express my thanks to the inventors of those magical eyedrops. She continues to remove the last remnants of the covering of my eye like one might remove a proof of purchase from a can of Jif to win the $300,000 grand prize, gently now, don't want to ruin the serial number.

  • PRK done on civilians! (Score:3, Insightful)

    by billnapier ( 33763 ) <napier@pob[ ]com ['ox.' in gap]> on Tuesday June 20, 2006 @03:17PM (#15571489) Homepage
    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.

  • The Army does this, too (Score:3, Interesting)

    by Animats ( 122034 ) on Tuesday June 20, 2006 @03:24PM (#15571547) Homepage
    The U.S. Army also offers free laser eye surgery to soldiers. Preference is given to combat troops. "The bottom line is that if you're in the middle of a fight and you can't see the enemy before they see you, you're dead". [defenselink.mil] The Army has been doing this since 2001. Combat troops with glasses are now considered obsolete.

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