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The Honolulu Advertiser
Posted on: Sunday, December 28, 2003

Laser eye surgery booms among troops

By William Cole
Advertiser Military Writer

Up until about three months ago, Army 2nd Lt. James Harris had 20/400 vision — bad enough that without glasses or contacts, it was difficult to recognize someone across the room.

Maj. Matthew Bushley, a doctor at Tripler Army Medical Center, examines 2nd Lt. James Harris' eyes after Harris' laser surgery.

Richard Ambo • The Honolulu Advertiser
www.pathwaytovision.com

And that was a concern as he prepared for a yearlong deployment to Iraq.

"Going to a foreign country for an entire year," Harris said, "I guess there's always that small fear that if you come under attack or something happens at night and you fumble around and lose your glasses, I wouldn't be able to function or see who's friendly."

So Harris, 30, did what an increasing number of deploying soldiers have done: He went under the laser at Tripler Army Medical Center to have his vision corrected.

Tripler has been performing PRK and LASIK surgery on about 40 soldiers a week. At Schofield Barracks, news of the fast and relatively painless treatment has been passing by word-of-mouth among soldiers who don't want the hassle of glasses in a combat zone, and just want to see better.

Harris, who's with the 2nd Battalion, 11th Field Artillery, said he knows six soldiers who have had the no-cost eye surgery — four from his unit.

"In terms of the requests from infantry soldiers up at Schofield, we've seen a significant increase over the past several months," said Maj. Matthew Bushley, a doctor and director of the laser refractive surgery center at Tripler. "If I had to guess, I'd say it's probably two- to three-fold from pre-deployment levels."

Bushley said the results make for a night-and-day difference in vision and convenience.

Soldiers are able to put on their gas masks for the first time without having to worry about their glasses falling out or getting fogged up, they're able to use night-vision goggles without vision aids, and they can go into the field without having to worry about infections from dirty contact lenses.

Since Tripler established the laser surgery program in January 2002, its four board-certified surgeons have performed more than 5,000 procedures.

The hospital also has commitments to the Navy and Air Force, but Bushley said the focus for the past several months has been almost exclusively on taking care of deploying soldiers.

About 4,800 25th Infantry Division (Light) soldiers are leaving for Iraq duty in January and February, followed by 3,500 soldiers deploying to Afghanistan in March and April.

"There were several units or groups of individual soldiers that would call us and say, 'I've got 10 or 15 people that I work with, and we're interested in having the surgery,' " Bushley said.

The Army's Warfighter Refractive Eye Surgery Program has eight laser centers worldwide. The first Army PRK/LASIK center opened in May 2000 at Fort Bragg, N.C., after military doctors saw the success professional athletes and police and firefighters — other jobs with a lot of physical activity — were having with laser eye surgery.

Photorefractive keratectomy (PRK) and Laser-Assisted In-Situ Keratomileusis (LASIK) involve reshaping the cornea, the clear window of the eye, with an excimer laser to eliminate nearsightedness, farsightedness and astigmatism, Bushley said.

PRK surgery is done on the surface of the cornea after removal of the outermost skin cell layer. A bandage soft contact lens is placed over the cornea for several days until the skin cell layer is healed.

LASIK involves creating a hinged flap of corneal tissue that is lifted, laser energy is applied, and the flap is repositioned.

With LASIK, most patients see 20/20 or better the next day, but the flap never heals as strong as it was before surgery, and because of a perceived increased risk of eye injury, Bushley said about 65 percent of the procedures done at Tripler are PRK.

The laser fires for anywhere from 20 to 60 seconds per eye. Doctors at Tripler use a 50-power magnification viewer and a computerized tracker keeps the laser positioned properly.

"So if the eye moves a little bit underneath the laser, the computer keeps up with that," Bushley said.

He added that there is a small chance of complications or a patient not responding to the surgery.

Capt. Bill Venable, who commands about 140 soldiers with Charlie Company, 1st Battalion, 21st Infantry Regiment, said several of his soldiers recently underwent the procedure, which has become routine.

"I know soldiers who went into the field without complications within a week or so after the surgery," Venable said. "Putting drops in their eyes and wearing sunglasses, they seemed to be good to go."

Harris needed to return last week for follow-up treatment with the original LASIK procedure correcting his vision to 20/35.

"Now I can see perfectly," Harris said after the touch-up. "It alleviates a big dependency on glasses and (worry about) not being able to function in the field."

Reach William Cole at wcole@honoluluadvertiser.com or 525-5459.