Naval Base San Diego’s Refractive Eye Surgical Center
By Mass Communication Specialist 3rd Class Jake Berenguer
SAN DIEGO – Navy Refractive Surgery Center, located at Naval Training Center, (NTC) San Diego’s refractive surgical center provides active duty personnel with laser surgical procedures to improve vision and end their dependency on glasses or contacts.
In 2009 NTC performed more than 2,700 vision corrective laser procedures. Only active duty or reservists on active duty status are eligible for refractive eye surgery. Laser surgery allows service members to focus on their tasks without cumbersome contact lenses or glasses while deployed. Glasses or contact lenses are designed to compensate for the eye's imperfections, while laser surgery aims to change and improve the focusing power of the eye by reshaping the cornea.
“I was privileged to perform the first laser vision corrective surgery on a Navy pilot. Six weeks after receiving his refractive eye surgery he flew out to a aircraft carrier with the commander of the carrier air wing in his back seat and performed a daytime landing onboard the USS Abraham Lincoln (CVN 72),” said Capt. (Dr.) David J. Tanzer, Division Head for Naval Refractive Surgery at NTC.
The NTC clinic offers three types of refractive surgical procedures: Photorefractive keratectomy (PRK), Laser-Assisted In Situ Keratomileusis (LASIK) and implantable contact lenses (ICL).
“The pilot relayed to me while I was flying with him that he had never seen the carrier landing lights better than when he was flying the first time after he had had the surgery, which was a huge relief for me. I took great pride in the fact that the procedure that I was able to perform for him resulted in him having better perception than before he had the surgery,” said Tanzer.
PRK is completed with the use of an excimer laser that uses a cool ultraviolet light beam to precisely remove small bits of tissue from the surface of the cornea in order to reshape any irregularities in the patient’s cornea. Correctly reshaping the cornea focuses light into the eye and onto the retina, improving vision.
If the cornea has imperfections, the image on the retina may be blurry or somewhat distorted. There are three types of refractive errors: nearsightedness, farsightedness and astigmatisms. These refractive errors are usually easy to correct through virtually painless procedures, resulting in 95 percent improved visual accuracy.
LASIK and PRK procedures generally take less than a minute to complete and the patient remains awake throughout the procedure. The ICL surgery is about a 15 minute procedure. All three are ambulatory procedures so the patient can leave immediately after, although patients are advised to have a driver following the procedure.
There may be some discomfort or dryness of the eye after the numbing drops wear off, which is minimal and subsides quickly. Post surgery prescriptions generally include: antibiotics to prevent infection, anti-inflammatory medication to ease any swelling that may arise, and eye drops to keep the eyes moist and comfortable. However, it is not advised that patients swim or go in a hot tub for eight weeks following the operation to avoid damage or irritation from the water that could easily enter the eyes.
Unlike the LASIK or PRK, ICL does not involve the removal of eye tissue but rather, implants permanent contacts. During the procedure, a surgeon administers topical anesthesia to minimize discomfort. Though painless, patients have reported feeling pressure on their eyes during the procedure. At the beginning of the surgery, one or two small openings at the base of the cornea are used to position the lens. A gel-like substance is placed inside the eye to protect it while the lens is placed behind the iris.
“The recovery times for the procedures are fairly fast,” said Tanzer. “It takes a total of one month to recover from LASIK and PRK and three months to recover from ICL. A week of convalescent leave is granted and deployment is not recommended for three months after receiving ICL. LASIK and PRK patients receive two days of convalescent leave and cannot deploy for a month. Patients will see as well, if not better, after the surgery with no supplemental correction,” said Tanzer.
According to Tanzer, with the commanding officer’s approval, active duty personnel have the option of seeing civilian practitioners for visual acuity improving procedures, but cannot use military refractive centers for follow up care if they do so. One exception is military personnel on flight status are not authorized to see civilian visual practitioners for any ocular procedures as this could place their flight status at risk.
Beneficiaries interested in receiving the procedures are required to go through their TRICARE provider. Active duty or reserve personnel should contact any military optometry department to schedule an appointment for a refractive surgery consultation.
“I have had the privilege over the last 15 years of taking care of thousands of people in all aspects of ophthalmology. Be it cataract surgery, cornea transplantation or the myriad of other procedures we perform as ophthalmologists. I derive my greatest sense of satisfaction in being able to perform laser vision corrective surgery on war fighters, allowing them to focus on their jobs and be able to carry out their functions without the need for glasses or contacts,” said Tanzer.
For more information regarding NMCSD’s Ophthalmology Clinic visit: https://www.med.navy.mil/sites/nmcsd/patients/pages/ophthalmologyclinic.aspx