PRK vs Lasik

[kbarron]

Hello all,

I recently went to NAMI for my flight physical and it was determined that I met the pre-op requirements to get corrective eye surgery. Currently I only qualify as an SNFO, but I would like to see if by getting corrective surgery I can qualify for SNA because if possible, that would be my preference.

I was told by the docs at NAMI that I should get a certain form of custom Lasik including laser flap creation. During the eye exam with the flight surgeon he told me Lasik offered an easier recovery time and had less risk of getting scars on your eyes, etc, that would make the surgery ineffective for purposes of qualifying for SNA.

I went to an ophthalmologist in my area (MA, USA) and he told me he does not do Lasik , only PRK. He strongly believes PRK is the superior procedure despite the longer healing time and initial discomfort because it offers less risks overall compared to Lasik. He said the PRK can do the custom/waveform part of the surgery as well, and does not include the complications that come with having a slit cut into your eye even if it is laser created. I mentioned him the issue of potential scarring and he said that because my correction is so light (only -2 diopters) combined with antibiotics I should have 0% chance of getting a scar. He said that with Lasik, the flap never truly 100% heals back into your eye so there is always the risk of physical force or debris dislodging the flap ( I am concerned this may be a possibility during training.)

I am willing to undergo a bit more discomfort in order to reduce the risks of side effects. The civilian eye doctor I went to also says while he has performed 1000's of surgeries, he uses a room at an eye clinic in Boston to do his work and does not actually own the lasers. Any comments on this?

Any comments on what to look for in a good eye doc? Also, any comments from anyone who has done 1 or the other procedure and if you would do it again or make the alternative choice given the option to re-do. From what I understand they both offer the same end result if everything goes well.

 

[NUFO06]

I did LASIK at the Naval Hospital in Jax. I loved it, after a lovely ambien trip, I woke up with 20/20. LASIK was really my only option because your only down from flying for a couple of weeks.

The Navy waited along time before approving LASIk because of the flap issue. The Navy thinks its safe to get LASIK as a pilot, nfo, or seal. I don't think the flap thing is such a big deal.

Get a second opinion from a surgeon who offers LASIK. This guy you talked to maybe didn't want to buy the newer equipment to perform LASIK. It's a business so he is trying to sell you a bill of goods. Be careful, not all machines are created equal. You get what you pay for when it comes to eye surgery.

 

[MGoBrew11]

I had PRK done in 2011 and I'm currently an SNA. It sounds like you've done your research which is really important.

What NUFO said is true, the Navy is accepting LASIK now. If you find through your research that you would prefer LASIK, talk to a recruiter before you get it done on what the process is like to get approval. If you have trouble (I would not be surprised if a lot of recruiters do not know this is true), talk to one of the recruiters or flight docs on this forum.

I asked about LASIK initially and my doctor would not perform it on me as he said my corneas were too thin. He said I was a candidate for PRK, however. I have no regrets in getting it. There was definitely a lot of pain and a longer recovery process but I am still 20/20 and haven't looked back. As to what to look for in a good doc....kind of a gut feeling I guess. It was kind of nerve wracking handing someone $3500 to zap my eyes, so you have to take a bit of a leap of faith. Experience is obviously a huge factor. My doctor had been doing these surgeries for more than 20 years which made me a bit more comfortable.

 

[The_Pants]

Needing a correction for my eye sight to be eligible to apply for SNA/NFO led me to do my own research, seek various doctor reviews, and consult my brother. After conducting my own research, I went with PRK due to the fact that many articles verified that PRK had longer, lasting results, and some stated that it was unlikely for the patient to have chronic dry eye. I've been to a few ophthalmologists and they said the same thing, that basically PRK has a longer "life-span" and less degeneration. When I finally picked my doctor, during the consultation he also recommended PRK instead of LASIK due to my career choice and physical activity. He basically said that even though the flap from LASIK heals, there is still a chance, very rarely though, that the scar tissue from the flap may rupture during an intense physical activity setting it loose. He had done PRK on many pilots with great results and was using the latest technology. Also, I'm not sure if this goes for LASIK but I know with PRK if you need an enhancement, as long as your corneas are thick enough it can be done. I also concluded that the laser that actually reshapes your cornea in combination with your doctors experience is a major factor in your post-op results, especially if you have an astigmatism. I would recommend not only reviewing your doctors experience but also ask about the laser that is going to do the procedure and research that as well. Just like brenbuck said, I paid a hefty price too of $3600. Well worth it though.

My brother is currently a Marine officer who had the PRK procedure done through the Navy and he has never looked back or thought twice about having LASIK instead. PRK was recommended to him as well through the Navy. His final results were superior, 20/15 both eyes and my brother was practically blind without his glasses before the procedure. My results were 20/20. The only thing I have an issue with is that sometimes I get dry eye after sleeping. But after having the procedure done over a year ago this is what I would recommend if you want the best results from PRK, yeah the healing time is going to be long but you'll thank me after you have great post-op results. After the surgery make sure you get lots of rest, drink lots of water to hydrate your eyes, put in your lubricated eye drops very often, I mean like every 5-10 minutes, you want to make sure they stay lubricated. What was also recommended from my brother was after about 1-2 days you can use an ice pack to help with the swelling and pain. Make sure to take time off from work, wear sunglasses, safety goggles if you work in a hazardous environment. Make sure not to strain your eyes by watching TV or playing video games. And by all means wear your protective eyewear, they're goofy clear goggles you sleep with to make sure you don't rub your eyes during the night. I wore them for about 2-3 months.

 

[exNavyOffRec]

I had LASIK 14 years ago, no degeneration, and no dry eyes. I have worked with people that had PRK who are still having issues with dry eyes, but none of them have had any degeneration either.

 

[wplax26]

I got my PRK performed with the wavefront technology back in 2004 but it did start to degrade around 2012. Now I'm back up to about 20/40-20/60. Dry eyes have been a minor irritation, especially in the morning but never to the point where I bought eye drops or anything. The place I got it promised free "re-do's" but that is on the other side of the US now and I don't really want to take the risks of another surgery just yet. I'm not intending to sway you one way or the other just to paint a more complete picture of the surgery.

 

[kbarron]

Thank you for all the responses. Hearing from people who've done the same thing helps immensely in
researching my decision.

My next course of action is , like you guys have mentioned, to get at least a second opinion from a doctor who also performs LASIK. Luke NUFO said, at the end of the day it is a business and people tend to say what gets them a sale at the end of the day. I will also be sure to check about the laser itself that might be used in the surgery.

This doctor whom I spoke with quoted me a price of $5000 for PRK. It sounds like most people have gotten a significantly lower price than this ( $3500 and $3600 ). I will factor this in when speaking with another doctor.I do not want to spare any expense on the only two eyes I'll ever get but I also do not want to pay excessive amounts if it is avoidable. Has anyone heard of a price like this with their surgeries?

After speaking with the navy doc at NAMI, one thing I am concerned about with is potential scaring from PRK. I understand scarring is not possible from LASIK. According to the civilian doctor I spoke with I'm at minimal risk for this, and this is a point I definitely need to contend with another doctor on, but has anyone heard of scarring from PRK as a thing preventing people from getting accepted?

It's interesting that most people here who have said they got PRK also developed dry eyes - I had heard that was a chance side effect more closely associated with LASIK.

Can anyone comment on how long it took them to receive a waiver after having either of the surgeries done? This is after the mandatory waiting period.

 

[MGoBrew11]

I also had dry eyes for about a year. Not a big deal at all. I would just put an eye drop in and be fine. At this point, I can't remember the last time my eyes felt dry.

I turned in the waiver application the day my 6 month wait period was up and I got the go ahead from navy medical a week later. It's a fast turnaround if you're prepared. Save every last bit of paperwork related to the surgery including pre and post op stuff.

Good luck!

 

[kbarron]

An update to my situation , in the hopes this might provide useful information to anyone in a similar situation:

After evaluating the options, I underwent wavefront all-laser LASIK surgery in June '14. Results were great, and I was able to score a 20/15 on the vision test the next day (up from my previous 20/400!) .

I experienced dry eyes for several weeks following surgery, although they've pretty much tapered off. I still might need one or two drops per day first thing in the morning or late at night. Staying hydrated and getting a full nights sleep helps significantly. Although sitting at a computer for work all day definitely does not help!

I am currently waiting on the 6-month wait period before I can get another flight physical to qualify for SNA and get my waiver approved.

 

[JunkyardDog]

Thanks so much for the information. I was on the fence but I think you convinced me.

 

[kbarron]

Thanks so much for the information. I was on the fence but I think you convinced me.

Glad to hear it was helpful. If you have any more specific questions post up/pm and I'll do my best to answer.

 

[TnSig]

Welcome to the LASIK club. Best money I ever spent. 20/15 the day after surgery and was back to regular activity after a few days. It's been 4 years and I went through OCS with absolutely zero problems.