PRK and LASIK Information

[stuckindayton]

9 hours ago, UASHopeful said:

I am a civilian who is trying to apply for pilot slots with ANG units, but I know I need eye surgery. My doctor wants me to get LASIK, because he knows a good, local LASIK doctor, but I have been hearing from some people that LASIK only really gets approved for people who are already flying for them military, but if you're a civilian applicant for UPT, that you need to get PRK to get the waiver. I have read the AF Waiver Guide, and that seems to suggest that both are equally waivable, unless there's something I'm missing....

PRK or LASIK are equally acceptable for applicants.  There is no bias on the AF side.  You are correct that the concern with LASIK is flap stability, although many folks think the femtosecond (Intralase) flaps may be more stable than the traditional microkeratome flaps.

Many folks associated with the AF have gotten PRK as it was the original approved procedure and that drove momentum to stick with it.  Right now it's about 80/20 PRK to LASIK for trained flyers at AF centers.  Most people consider PRK to be more conservative as you're not cutting into the cornea, but there is certainly a slower recovery.

Regarding finding a surgeon, my only advice is to 1) Find someone who does it as their main practice (i.e. does a lot), 2) Isn't competing for the lowest price in town and 3) Uses a top quality laser.  That goes alone with #2.  Docs who work on the cheap use old, lousy lasers.

[UASHopeful]

13 hours ago, stuckindayton said:

PRK or LASIK are equally acceptable for applicants.  There is no bias on the AF side.  You are correct that the concern with LASIK is flap stability, although many folks think the femtosecond (Intralase) flaps may be more stable than the traditional microkeratome flaps.

Many folks associated with the AF have gotten PRK as it was the original approved procedure and that drove momentum to stick with it.  Right now it's about 80/20 PRK to LASIK for trained flyers at AF centers.  Most people consider PRK to be more conservative as you're not cutting into the cornea, but there is certainly a slower recovery.

Regarding finding a surgeon, my only advice is to 1) Find someone who does it as their main practice (i.e. does a lot), 2) Isn't competing for the lowest price in town and 3) Uses a top quality laser.  That goes alone with #2.  Docs who work on the cheap use old, lousy lasers.

So there's no concern about certain procedures limiting me from certain airframes?

I'm surprised that the vast majority of applicants in the AF centers have had PRK, as I've been having a hard time finding good doctors that do it as their primary practice. I'm figuring that PRK may just be the way to go, as everyone I have talked to has recommended it, but I don't know how people found good doctors. I guess I'll just have to go with one who has good reviews and seems to have experience and good equipment and just take the plunge.

[stuckindayton]

There are no longer any limitations on airframes after PRK or LASIK.  Any reference to that is outdated.

I didn't mean that docs do PRK as their main practice, I meant they do a lot of refractive surgery.  In the civilian world, that means LASIK because civilians want quick, painless recovery.

Most civilian docs are going to be fully competent.  I would just shy away from the guy advertising on the Sunday paper for $250 and eye.  Anyone quoting really low prices is not using top quality equipment as the good lasers have a click fee (the doc has to pay a fee every time they use it).  So cheap procedures are using old, cheap(er) lasers that don't have a per use fee.

[ThreeHoler]

LASIK is generally available to the public for a lower cost than PRK. I had wavefront guided PRK at Lackland which would cost around $5000/eye if I'd had it done at a civilian center. Wavefront guided LASIK would have been about 1/5th of the cost per eye.

The docs at Lackland do around 10-20 surgeries a day. They recommend PRK or LASIK based on your particular eyes. Don't get stuck on one procedure or the other. But read about both to know what you're getting into.


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[ThreeHoler]

By the way...stuckindayton is right. Lackland pays the click fee for those 20-40 eyes five days a week. They have really impressive top of the line equipment that most civilian eye doctors don't have because the costs are too high.


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[Hopefulflyer389]

On 2/20/2017 at 7:38 PM, UASHopeful said:

I am a civilian who is trying to apply for pilot slots with ANG units, but I know I need eye surgery. My doctor wants me to get LASIK, because he knows a good, local LASIK doctor, but I have been hearing from some people that LASIK only really gets approved for people who are already flying for them military, but if you're a civilian applicant for UPT, that you need to get PRK to get the waiver. I have read the AF Waiver Guide, and that seems to suggest that both are equally waivable, unless there's something I'm missing.

   I'm a pilot hopeful as well and I can give some insight on the procedure itself as I was in the same situation as you back in June 2016 when it came to choosing. I went to a facility that offered both wave front LASIK and PRK. Wave front LASIK was the best option for me and I’m glad I went that route. Pre-surgery was -2.75 in my left and -1.50 in my right. Had the procedure 1800 on a Thursday and woke up at 0700 on a Friday, drove to the facility for my post op, and read 20/15 on the chart.

    Been great ever since and now I can almost read the 20/10 line in some situations. I had no complications, but there is some fluctuation in your vision during the first few weeks. It wasn’t cheap as a I paid $3,750.00 for both eyes. This came with unlimited visits for a year, free touch up if needed for the first year, and then any other touch ups needed would be $800.00 each eye.

    I was very fortunate to find the location that I did as the optometrist use to fly and the ophthalmologists was prior Air Force, so they were completely accommodating to the needs of extra visits and filing out the paperwork. I have attached a copy of the form that you mentioned in your previous post and this is what I had filled out; not sure if it’s still the current form. Someone in the know how can give a better answer in regards to current paperwork.

     As mentioned by others when choosing a location, be up front with your needs (extra visits, quick access to paperwork, etc.) to make sure they can accommodate them, they take the time to answer ALL of your questions, and the time frame for them to see you is minimal; the time you wait around will reflect their ability to comply with your needs.  Reply back or send me a PM if you have any more questions on the procedure.  

AFD-150310-028.pdf

[UASHopeful]

Thank you very much for the insight, as well as the link to the form.

[Edw26]

For a civilian applying to ANG/AFRES, anyone know roughly how long it takes for a PRK waiver to be approved?

[stuckindayton]

9 hours ago, Edw26 said:

For a civilian applying to ANG/AFRES, anyone know roughly how long it takes for a PRK waiver to be approved?

It doesn't change the time to process your physical.  I think they say around 4-6 weeks.

[Edw26]

30 minutes ago, stuckindayton said:

It doesn't change the time to process your physical.  I think they say around 4-6 weeks.

Thanks

 

 

[stuckindayton]

1 hour ago, Zulu said:

I have been in contact with an AD and ANG recruiter who have told me different things about the time I need to wait after having eye surgery. One says it is 6 months and the other 12. Also, is this time measured from the date of my surgery to the date of my application, MEPS, or FC1/MFS? Any help would be great.

There is a mandatory 6 month wait between surgery and your IFC I/MFS.  It used to be 12 months, but that changed several years ago.  However, that is probably why you are getting two different answers.  I have no idea how MEPS works into the equation.

[mattey22]

Just a quick question, I asked my doctor and he said that I am in range of all of the requirements (Myopia, Hyperopia, and Astigmatism). But I have pretty poor vision, I can sometimes read 20/200 and other days I'm unable to. From what I have read is that recently they have removed visual acuity, but should I still consider getting eye surgery?

[Hopefulflyer389]

On 11/6/2017 at 4:16 PM, mattey22 said:

Just a quick question, I asked my doctor and he said that I am in range of all of the requirements (Myopia, Hyperopia, and Astigmatism). But I have pretty poor vision, I can sometimes read 20/200 and other days I'm unable to. From what I have read is that recently they have removed visual acuity, but should I still consider getting eye surgery?

That’s entirely up to you. I was -2.75 in my left eye and would be -3.00 (about 20/200 if I remember correctly) on a bad day which is the cutoff. So, I had LASIK and never regretted it as now I have 20/15 in both eyes. 

[stuckindayton]

On 11/6/2017 at 5:16 PM, mattey22 said:

Just a quick question, I asked my doctor and he said that I am in range of all of the requirements (Myopia, Hyperopia, and Astigmatism). But I have pretty poor vision, I can sometimes read 20/200 and other days I'm unable to. From what I have read is that recently they have removed visual acuity, but should I still consider getting eye surgery?

Mattey,

Your refractive error, i.e. glasses prescription, is all that matters.  If you are over -3.00, there is no waiver.  So don't base it on 20/200 (better or worse) as that doesn't matter.  You need to know if you exceed -3.00.

[mattey22]

1 hour ago, stuckindayton said:

Mattey,

Your refractive error, i.e. glasses prescription, is all that matters.  If you are over -3.00, there is no waiver.  So don't base it on 20/200 (better or worse) as that doesn't matter.  You need to know if you exceed -3.00.

Thanks for the heads up, I will confirm with my eye doctor soon and I'm sure he can give me a definitive answer as I do not remember off of the top of my head. And I can not exceed -3.00 pre-surgery correct?

[stuckindayton]

1 hour ago, mattey22 said:

Thanks for the heads up, I will confirm with my eye doctor soon and I'm sure he can give me a definitive answer as I do not remember off of the top of my head. And I can not exceed -3.00 pre-surgery correct?

No....the pre-operative limit for refractive surgery is -8.00. 

[mattey22]

41 minutes ago, stuckindayton said:

No....the pre-operative limit for refractive surgery is -8.00. 

Great so as long as it is all in check, and even if I need the surgery, I should be fine as long as my corrected is better than that afterwards. Thanks for the clarification.

[Stoker]

You can try to get an Exception to Policy, but it ain't gonna happen unless you've got some pull with a US Senator or the President to push the right buttons for you.

[mattey22]

On 11/8/2017 at 2:41 PM, Hopefulflyer389 said:

That’s entirely up to you. I was -2.75 in my left eye and would be -3.00 (about 20/200 if I remember correctly) on a bad day which is the cutoff. So, I had LASIK and never regretted it as now I have 20/15 in both eyes. 

Still no problems with the procedure? How long of a recovery time ( I know it varies by each person), but I heard most people are up and going the next day?

[Hopefulflyer389]

No problems whatsoever and was reading 20/15 the next morning. The facility will provide all the needed pre and post op information. I can’t stress enough that you need to follow the instructions to a T. Also, I was using the Oasis artificial tears for post op and would place them in the fridge; the coolness aided with any discomfort I had. 

[nsplayr]

22 hours ago, mattey22 said:

Still no problems with the procedure? How long of a recovery time ( I know it varies by each person), but I heard most people are up and going the next day?

As another data point, I had LASIK done at Keesler AFB in July 2011. Very similar stats to Hopefulflyer above...I was 20/200ish before the procedure, sat up in the chair immediately following at 20/15. Today more than 6 years later I'm between 20/15 and 20/20 depending on how hard I try on the test. Zero complications and I was in the casino the next day post-op (that afternoon/evening you feel pretty beat up). In general the LASIK recovery is a cake walk compared to PRK, at least from guy I know compared to my own experience.

[OTR]

All,

 

Can someone  take a look at these docs and let me know if I meet minimum requirements to pass an Air Force Class I physical without refractive surgery? I am currently correctable to 20/20 with glasses. Thanks.

[stuckindayton]

10 hours ago, OTR said:

All,

 

Can someone  take a look at these docs and let me know if I meet minimum requirements to pass an Air Force Class I physical without refractive surgery? I am currently correctable to 20/20 with glasses. Thanks.

The cycloplegic refraction was not done the way it would be done with an IFC I exam.  This is a refractive surgery application where they measure your cycloplegic refraction to BEST acuity, in this case 20/15.  During an IFC I we only go until you can see 20/20.  It should be at least 0.25 diopters and often 0.50 D to 0.75 D less than your manifest refraction.  Assuming no changes between this exam and your IFC I, your right eye meets criteria.  I would expect your left eye would come down from -3.50 to -3.00, but that's not a guarantee, however highly likely.  BTW- You would appear to be a very good refractive surgery candidate if your prescription is stable.

[OTR]

The cycloplegic refraction was not done the way it would be done with an IFC I exam.  This is a refractive surgery application where they measure your cycloplegic refraction to BEST acuity, in this case 20/15.  During an IFC I we only go until you can see 20/20.  It should be at least 0.25 diopters and often 0.50 D to 0.75 D less than your manifest refraction.  Assuming no changes between this exam and your IFC I, your right eye meets criteria.  I would expect your left eye would come down from -3.50 to -3.00, but that's not a guarantee, however highly likely.  BTW- You would appear to be a very good refractive surgery candidate if your prescription is stable.

Thanks I am scheduled for PRK/LASIK surgery in Jan still deciding which one since I can do both. But I was thinking about putting it off if I qualify because of my age and UPT. I assume there is no waiver for the -3.00 limit??

[stuckindayton]

Correct, no waiver for above -3.00.  It's obviously a little bit of a gamble to put off PRK and LASIK and qualify as is, but your odds are very good.