Refractive surgery bringing life into focus Published March 25, 2008 By Ann Patton Academy Spirit staff U.S. AIR FORCE ACADEMY, Colo. -- Forget "four-eyes" or dried out, dirty contact lenses. The Academy's Refractive Surgery Center is doing away with the need for glasses and contacts and doing it with the most technically-sophisticated equipment available. Operational since 2001, the center at the 10th Medical Group has performed more than 15,000 refractive eye surgeries since it opened. The center prides itself on providing the highest quality eye care to patients from the Army, Navy, Coast Guard and Air Force, including members assigned to Peterson Air Force Base and the 21st Space Wing. "Overall, almost 90 percent of patients are seeing 20/20 or better without glasses or contacts, and virtually all are 20/40 or better, the legal driving limit," said Maj. Derrick Montgomery, 10th MDG ophthalmologist, Corneal Specialist and the chief of the Refractive Surgery Center. The 10th Medical Group hospital was recently acknowledged as the top Air Force hospital in the continental U.S. and the USAFA is fortunate enough to have a Laser Center commensurate with its prestige. Led by some of the most qualified physicians, optometrists and administrators in the Department of Defense, the center is forging into the new millennium, utilizing the most innovative technology. "Our equipment is state-of-the-art," said Paul Dondi, center manager. "It's the best on the market." For deployed warriors, refractive surgery is especially attractive because it eliminates the need for vision corrective gas mask inserts and modifying night vision goggles to conform to eyeglasses. The center boasts a 99 percent pilot-qualifying success rate on pilot candidates who have received laser surgery at the Center. "Most people are good candidates," Major Montgomery said of the two kinds of refractive surgeries, which would come with hefty price tags off base. Mr. Dondi, estimated the cost for the elective surgeries could run between $4,000 and $5,000. The cornea functions much like the lens of a camera, with the retina as the film. Refractive surgery involves reshaping the cornea to make light rays fall precisely on the retina. The center also provides patients with the opportunity to have a Wavefront or CustomVue profile created. The latest advancement is excimer laser computer software technology. The systems allow the computer to ascertain an individualized representation of every patient's eye and provide a treatment profile, which is unique to only that eye. Even James Bond would be impressed with this program, which includes an "iris registration" capability or an "iris fingerprint," to identify subtle, one-of-a kind differences unique to that particular eye, enabling the clearest possible vision after surgery, in many cases even better than 20/20. There are several types of refractive surgery but two in particular are most commonly performed at the center: Photorefractive keratectomy, or PRK, involves removing the top layer of cells on the cornea. A laser is then applied directly to the corneal stromal bed that remains, reshaping the cornea and allowing for better vision. The second refractive surgery is Laser in Situ Keratomileusis, or LASIK, and is a variation of PRK. LASIK involves creating a paper thin corneal stromal, or flap. The laser is applied to the corneal bed once the flap is lifted and retracted. The corneal flap is then replaced in its original position. The decision to have PRK or LASIK depends on the individual characteristics of the candidate's corneas and is subject to the surgeon's discretion. Major Montgomery pointed out the recovery time for LASIK is considerably faster, and post-operative drops are usually discontinued within one week after the procedure, allowing for faster troop deployments than PRK. Though intricate and requiring a highly skilled medical team, refractive surgery is surprisingly fast, and any discomfort afterward can be relieved with topical and oral medications. Following pre-operative procedures, patients are in the laser surgery suite only about 10 minutes for surgery on both eyes. However, patients must undergo eight follow-up examinations after having PRK. "The safety of the patient is paramount," Major Montgomery said, and added the center needs to monitor patients closely. Following surgery, the Air Force requires retainability for six months, the Navy 12 months and the Army 18 months. The Academy performs about 25 refractive surgeries a day but always welcomes new patients. "There is practically no waiting period," Mr. Dondi said. "The USAFA Refractive Surgery Center is honored to serve those who serve our country so tirelessly, and provide them with the best quality vision science has to offer," said Major Montgomery. "Maybe you can be next!" To apply for refractive surgery on the Academy, e-mail 10mdg.lasereyeclinic@usafa.af.mil. To learn more about refractive surgery, visit here