LASIK For Pilots and Astronauts

    OCEAN CITY, NJ, September 28, 2008 /24-7PressRelease/ -- Traditionally, poor vision has been the number one disqualifier for the National Aeronautics and Space Administration (NASA) and U.S. military pilot applicants. The reason was concern that people depending on glasses or contact lenses would be unable to function fully should something happen to break the glasses or lose the little contact lenses. Zero gravity conditions make contact lens maintenance difficult.

After LASIK gained FDA approval, the concerns remained, with the additional concern over the LASIK flap.

LASIK Flap Concern
Before a LASIK surgeon applies the laser for vision correction, he or she cuts a surface flap on the cornea (clear front part of the eye), to expose the next layer down. The flap is replaced after treatment, and heals by itself. But in stressful environments, that flap tissue could separate again and cause vision problems.

Exposure to high altitudes and the wind pressure during aircraft ejection create changes in air pressure which can affect vision. Similarly, astronauts have to deal with such pressure changes during liftoff and space walks outside their vehicle; and there is also the harsh condition of dry air. Navy personnel may be dealing with under-water pressures which are far higher than in the atmosphere.

DoD Research
The Department of Defence (DoD), especially the Navy, therefore embarked on its own decade of vision research, starting in the mid 1990s. The DoD wanted to retain more of its highly-trained personnel, even if aging was impairing their eyesight. Researchers looked into PRK, and IntraLase as being possibly safe procedures.
• PRK is laser vision correction which does not involve any corneal flap. Instead, surface corneal tissue is gently removed altogether to expose the treatment layer. Then the eye will regrow the surface cells. During the two weeks or so of recovery, the patient wears a contact lens "bandage" to protect the treatment area.
• Intralase is another type of laser vision correction which uses a second laser to create the corneal flap. This makes the flap creation more precise and more tailored to each individual eye. In a typical LASIK surgery, the flap is cut with an oscillating blade. But using a laser to do it is safer.
• Wavefront-Guided LASIK is a huge refinement of the original LASIK first approved by the FDA in the mid-1990s. A wavefront-guided treatment is far more customized to each individual eye, and corrects for more than just the lower order aberrations (nearsightedness, farsightedness and astigmatism). It also corrects for the higher order aberrations such as poor night vision and ghosting (faint duplicate images). This gives a higher quality of vision as well as more quantity of vision.

Navy Approval
The navy approved PRK for its pilots in 2004, requiring them to take a three-month recovery period. Since there is no corneal flap in PRK, all the potential complications of those flaps are avoided. These complications comprise the main risks of a standard LASIK surgery - flap wrinkle formation during healing, flap detachment, faulty flap creation (no hinge, a hole in the center, etc.), infection beneath the flap.

NASA Approval
In 2007, NASA and the Navy began allowing applicants to have had IntraLase or PRK. They specified that one year must have passed since the surgery, with no permanent negative effects. Their approval was given to AMO's (Advanced Medical Optics) Advanced CustomVue LASIK done with the IntraLase method (this procedure is also now called iLASIK). They decided that this particular combination of technologies was superior in safety and vision results, and that astronauts and fighter pilots would not be hampered in their duties by any negative after-effects.

NASA also allowed existing personnel to have iLASIK as long as they then accepted a position which kept them out of any challenging environments for a year.

If you are interested in having any type of laser vision correction, contact Dr. Omar Almalla for more information.

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