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THE EYES HAVE IT - Refractive surgery gives service members combat edge through vision

Maj. (Dr.) Vashuda Panday lifts the corneal flap of Army Staff Sgt. Stanley Arnold as a step in his LASIK refractive surgery March 3, 2011, at Lackland Air Force Base, Texas. Dr. Panday is the chief of cornea refractive surgery at the Joint Refractive Surgery Center and Sergeant Arnold is an instructor and infantryman at Ft. Huachuca, Ariz. (U.S. Air Force photo/Staff Sgt. Mareshah Haynes)

As a step in LASIK refractive surgery, Maj. (Dr.) Vashuda Panday lifts the corneal flap of Army Staff Sgt. Stanley Arnold last year at Lackland AFB, Texas. Panday is the chief of cornea refractive surgery at the Joint Refractive Surgery Center, and Arnold is an instructor and infantryman at Ft. Huachuca, Ariz. (U.S. Air Force photo/Staff Sgt. Mareshah Haynes)

LACKLAND AIR FORCE BASE, Texas -- Three Air Force and eight Army surgeons at the Wilford Hall Medical Joint Refractive Surgery Center at Lackland Air Force Base, Texas, are helping service members sharpen their combat edge by sharpening their vision.

Active-duty military members from all branches of the service travel to the first joint refractive surgery center to get corrective surgeries. The center is also home to the only Air Force residency program for ophthalmologists and a Department of Defense Center of Excellence.

"We're the busiest refractive surgery center in the Air Force, performing upward of 4,000 surgeries in a year here, which is an enormous amount of surgery," said Lt. Col. (Dr.) Charles Reilly, the consultant to the surgeon general for refractive surgery. "Our other big mission that we have here is research. We're actually trying to push the boundaries of what is known and not known about laser vision correction and what the potential is for the future in Air Force refractive surgery."

Patients will choose either LASIK or PRK based on their eyes and the benefits each procedure has to offer.

"The determining factors are the structure of the cornea," said Maj. (Dr.) Vashuda Panday, the chief of cornea refractive surgery. "There are certain guidelines we follow based on our research in the ophthalmologic community. It's really the structure and the shape of the cornea that determines what the eye is better suited for. There's nothing that says you must get one or the other. Really, it's your eyes that determine what you can get, and of course, if you have a preference and that matches up with your eyes. In other words, if your eyes qualify for one or the other, that determines which procedure you're going to get."

Another big deciding factor for patients is the recovery time from the surgery.

"(With) LASIK we're actually cutting a flap into the cornea," Panday said. "It's a piece of tissue that's lifted and actually placed back. With PRK, we're actually just removing the surface skin cells and then letting the laser do its job. There's a slightly different healing process between the two, but that's the main difference.

"LASIK has a faster visual recovery, usually a day or so," the doctor added. "It's a lot less uncomfortable overall. When you remove skin cells like we do with PRK, there is a healing process and also involved is some measure of discomfort. With LASIK, since we don't touch the skin cells too much, there is a faster recovery in terms of vision and (patients) have a lot more comfort and less pain over all."

The refractive surgery program is designed as a readiness force enhancer to help service members perform better in combat than they could with contact lenses or glasses.

"If you can see the enemy 100 miles sooner than the enemy can see you, you have the advantage," Reilly said. "We're about giving you the advantage in combat. We want to give you what we call the "combat edge" in vision. Just like when you upgrade avionics systems in an F-15 or an F-22, you want your radar to be able to see the enemy long before their radar can see you. That's how we look at vision. We're upgrading the 'avionics' of the human weapons system."

One recently "upgraded weapons system" is Army Staff Sgt. Stanley Arnold, a combat tactics instructor at Ft. Huachuca, Ariz. The infantryman, who wore glasses for the past 18 years, spent more than five months going through the process to get LASIK surgery but said it was worth the wait.

"I think one of the biggest motivations behind getting the LASIK done was because of my job," Arnold said. "When I'm not instructing, and I'm in a line unit, I'm an infantryman. Whenever you go out on a patrol, it's critical that you're always ready at a moment's notice. But ... contact lenses are not allowed, so you always have to have those different sets of glasses. You have to have your clear lenses, your dark lenses, maintain the inserts for your goggles, your protective masks. So depending on what the mission is, I always have to make sure those things are ready to go."

Even with glasses, Arnold said his vision wasn't the best it could be to accomplish his mission.

"One of the things I don't like about glasses is that it takes away from my peripheral vision," he said. "Now, I know I'll get my peripheral back and that makes me feel better with deploying. Being an infantryman, I know for a fact I will deploy eventually. I'm very happy with it. I'm on cloud nine."