Seeing the Light - photorefractive keratectomy - Brief Article

Thanks to technology, outpatient laser eye surgery blinks out prescription spectacles and focuses on barrier-free vision.

Things became clear to me in the 6th grade. I wasn't a young sage. The ophthalmologist was the true guru. He took me to the window and held lenses to my eyes. I watched cars at the traffic light across the street and clearly saw what I'd been missing.

That epiphany two decades ago has dulled over the years. Although I felt fortunate for my vision, wearing glasses that make you look like a bug wasn't exactly glamorous. (Of course, my Brillo-pad perm and braces didn't help the situation.) After all, there's only a few pre-pubescent years that "Four eyes are better than two" is a mature response.

Then came soft contact lenses in the 1980s. My all-too-practical mother wouldn't hand over the $95 for contacts when I had "perfectly good glasses." And I wasn't about to explain how inconvenient spectacles were for kissing boys. As luck would have it later, during the summer of 1986, my glasses shielded my face from a speeding softball.

"Can I get contacts now?" I asked Mom as I held out the pieces. It worked.

Again I felt rejuvenated by the gift of sight -- just in time for my senior year in high school. Not only did boys start to notice me but there were no more foggy lenses when I went inside on winter days. In northern Michigan the latter was a bigger bonus.

I regressed with the deplorable glasses of basic training. And quickly went back to the comfort of my contacts after graduation.

After my first child was born, I realized how much easier it was to put on glasses than contact lenses so I focused on the nose-propped version to catch a little more sleep. Unfortunately, there were risks -- sticky fingers were attracted to glasses, and so were raindrops.

Near- and far-sighted people alike can tell you about the nuances of falling asleep in daily-wear lenses and wiping sweat residue from glasses after aerobics. Then there are the nose prints from those you love and the blurred outlines of unrecognizable people waving from the other side of the pool.

But technology has an answer for the visually challenged. And now, so does the Air Force. It's a laser eye surgery -- called photorefractive keratectomy. With PRK a thin layer of the cornea -- approximately three sheets of paper thick -- is removed with a laser to correct vision without damaging neighboring cells. The cornea is reshaped to reduce the patient's dependence on glasses. In my case, the only glasses I needed a week after surgery were sunglasses.

As great as it sounds, the procedure isn't risk free -- and it's more serious than dodging sticky fingers and raindrops. Although major complications are rare, hazy corneas, dry eyes, decreased night vision, scarring and loss of vision are the biggest concerns. And the only certainty is that the outcome isn't certain, which made my decision difficult.

After two months of appointments and countless tests, the day arrived. I looked at the world one last time with my 20/300 eyes. I had the opportunity to watch the process, including the "scrubbing" of my cornea with an instrument resembling an electric toothbrush. While a noise similar to metal in a clothes dryer echoed in the room, I stared at a flashing red light. Eighteen seconds of laser treatment in my right eye and 22 seconds in my left. That was it. I was sent home with a brown paper lunch bag full of medications.

Although time under the laser is brief, the healing process takes longer and varies from patient to patient. The pain level also varies significantly. Some experience slight discomfort, others severe pain.

When I lost a clear protective contact "bandage" during the first night, I swore someone threw dirty bleach at me. My left eye was so sensitive to light and watered so intensely it seemed to make noise. But at my first post-op appointment the next morning, relief was instant when the missing bandage was replaced. The rest of my recovery was relatively painless.

As ridiculous as it sounds, while recovering I realized how much I depended on my eyes. No driving, no reading, no writing, no computer and no television -- I couldn't see much for the first three days. So I slept.

But every few hours, when the pain killers wore off and it was time to apply my eye-drop medications, I opened alternate eyes to gauge my progress. Things were blurry, and I was sure the surgery didn't work.

Well I was wrong; the surgery was a success. I've had perfect vision -- 20/20 -- since a month after my surgery. Although seven months later I still catch myself trying to push up my invisible glasses, I have no complaints and experienced no significant side effects. I even donated my two pairs of glasses to the Lion's Club. The box in the PRK clinic at Wilford Hall Medical Center is overflowing with them.

I also decided to rid my medicine cabinet of vision products. I threw out so many different contact lens containers, solutions and disinfectants it got me thinking. I calculated what I've spent to improve my vision over the last 20 years -- approximately $5,000. Did I mention the only things I buy these days are sunglasses?

Coming to a base near you

In January, Wilford Hall Medical Center at Lackland Air Force Base, Texas, started a photorefractive keratectorny center catering to active duty Air Force people.

Medical centers at Wright-Patterson Air Force Base, Ohio, and the Air Force Academy, Cob., started operating this summer. Two additional centers are expected to open next fiscal year at Keesler Air Force Base, Miss., and Travis Air Force Base, Calif., according to the surgeon general's office.

About 40 percent of today's Air Force members require corrective lenses to perform their jobs. Medical officials hope reducing war fighters' dependence on corrective lenses will improve the ability to perform their jobs, and the approximately 400 PRK patients at Lackland are likely to agree.

COPYRIGHT 2001 U.S. Air Force, Air Force News Agency
COPYRIGHT 2001 Gale Group