April 28, 2004
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Army study: Refractive surgery improves combat readiness

FORT LAUDERDALE, Fla. — A 3-year study in U.S. Army soldiers found excellent clinical outcomes of refractive surgery and substantial improvement in “soldier readiness” as a result. The study was presented here at the Association for Research in Vision and Ophthalmology (ARVO) meeting.

“This study came about through recognition of the tremendous importance of vision to our soldiers,” said M.D. Hammond, MD, of the Walter Reed Army Medical Center in Washington. “Battlefield conditions put extreme stress on the soldier and their vision.”

The Army Warfighter Refractive Eye Surgery Program (WRESP) was designed with the intention of decreasing the limitations posed by corrective eyewear on combat soldiers.

Monthly reports gathered from seven WRESP laser centers detailed the numbers and types of procedures performed, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA) and significant intraoperative or postop complications.

A total of 25,642 eyes of 16,091 servicemen and women were treated in WRESP between May 2000 and October 2003. PRK was performed in 60% of eyes, LASIK in 32%, and LASEK in 8%. Postop UCVA was 20/20 in 85.6%, 20/25 in 91.8%, and 20/40 in 98.1% of eyes with at least 3 months follow-up. No more than 1 line of BSCVA was lost in any eye at 3 months or longer postop.

As another part of the study, soldiers with previous refractive surgery who were returning from deployment completed a questionnaire about their vision. These soldiers rated the effects of refractive surgery on their ability to perform tasks such as night operations, weapons sighting, operations in extreme environmental conditions and the ability to use personal protective equipment. The scale was from 1 (much worse) to 5 (much better).

In the surveys, 90.2% of patients rated their overall readiness as better or much better after surgery. the score for overall soldier readiness was 4.69; night vision, 4.41; weapons sighting, 4.65; and environmental conditions, 4.1.

Two survey respondents claimed to have worse or much worse night operations skills postop, and two reported difficulty with adverse conditions such as heat, dust and dryness. None of the patients reported worse overall readiness after surgery.

“The WRESP program has provided excellent results,” Dr. Hammond said. “It was not uncommon to go through those questionnaires and see comments like 'This was the best thing the military ever did for me.'”