July 2016




Chief medical editors corner of the world

Reflections on refractive surgery in the military

by Eric Donnenfeld, MD, EyeWorld chief medical editor


Eric Donnenfeld, MDEric Donnenfeld, MD


The first rule of combat is to see the enemy. And that is precisely the refractive surgery advantage that our military now possesses. I recently spoke to a general in the United States Army, and he explained that it isnt advanced weaponry but rather refractive surgery that is the single greatest advantage our troops have on a daily basis. Think about that for a moment. Too often we lose sight (no pun intended) of the significance of refractive surgery. This issue of EyeWorld highlights the importance of refractive surgery for our military personnel and first responders. I cannot think of a more important topic. Every day our nation is more secure and our first responders, who place themselves in harms way on our behalf, are safer and more effective because they have the advantage of LASIK, PRK, and phakic IOLs. We all know that refractive surgery changes patients lives, but it also saves lives as well. The PROWL study, which was 2 separate trials, 1 in the military and led by Captain Elizabeth Hofmeister, MD, of the Navy and the other in private practice, showed overwhelmingly that LASIK reduces patients symptoms (such as glare, halo, and starburst) while increasing the quality of their vision and reducing/eliminating the need for contact lenses or glasses. The military has also extensively studied LASIK, and we owe a great deal to the military ophthalmologists who have advanced refractive surgery for all of us; their well- performed, credible clinical trials have substantiated the safety and efficacy of refractive surgery. Steven Schallhorn, MD, is universally recognized as the father of refractive surgery in the military, and as the refractive editor of EyeWorld, he has brought the same dedication to our publication. His contributions to this issue provide a historical perspective of how LASIK has changed the military. One of my favorite papers was authored by David Tanzer, MD, with Dr. Schallhorn and investigated the efficacy of LASIK in Naval aviators. I cannot imagine a more daunting challenge than landing a jet on an aircraft carrier in rolling seas at night. In their study, 95.9% of pilots felt that LASIK enhanced their ability to perform their jobs and made them more effective.1 Refractive surgery has also opened up the population of eligible candidates for military service and first responders. I will never forget my personal experience of performing LASIK on an individual whose greatest wish in life was to serve our country. Following refractive surgery, he was able to pursue his dreams and became a Medal of Honor winner, the highest award given in the military. Young men and women who wish to join the military or become firefighters, police officers, or other first responders are no longer automatically considered handicapped by their vision, which has greatly improved the candidate pool. There have also been positive repercussions in the military. In the past the most highly qualified individuals who were unlucky enough to have poor vision ended up in second- or third-choice occupations. These individuals no longer have limitations on their jobs in the military.

Refractive surgery is safe, effective, and good for our country. When you finish reading this issue of EyeWorld, spend a little time thinking about our military personnel around the worldand especially about their dedication and sacrifice.


1. Tanzer DJ, et al. Laser in situ keratomileusis in United States Naval aviators. J Cataract Refract Surg. 2013;39:104758.

Contact information

Donnenfeld: ericdonnenfeld@gmail.com

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