July 2016




Refractive surgery options within the Army


Colonel Scott Barnes, MD, chief, U.S. Army, Warfighter Refractive Eye Clinic, Fort Bragg, North Carolina, said that the breakdown of LASIK and PRK within the Army is about 70% surface ablation and 30% LASIK, although he noted that it can vary widely depending on the location. About 5 years ago at Dr. Barnes hospital, this number was nearly 100% surface ablation. Now, there are roughly 5560% LASIK cases.

As for phakic IOL use, Dr. Barnes said that these are a fantastic option for the right patients. However, he noted that its not something thats offered to everyone. Its a little different than in civilian clinics, he said, because the Army has a large number of young patients, who may be in their early 20s or younger. Looking at those young patients, its not uncommon for them to have some topographic irregularity in the cornea. Although thats not necessarily concerning, it may indicate the beginnings of keratoconus in younger patients. ICLs have opened up the options for young patients who may have to wait for some years to be sure the corneal irregularities are not progressing if they want to consider laser surgery, Dr. Barnes said. Those who have previously had a phakic IOL are currently disqualified from entering military service, Dr. Barnes added. These patients have the potential for future issues such as retinal detachments and other vision concerns, and their pre- and postoperative records are often unavailable. One of the biggest things that I remind people is that for us in the Army, this is not a cosmetic program, Dr. Barnes said. The bottom line, he said, is that were asking these soldiers to do the countrys bidding and this could involve tough situations with tough people who may wish to do our soldiers harm. If you cant see them before they see you, that could put your life on the line. Its an amazing thing for soldiers to be free from glasses or contacts, Dr. Barnes said. We dont want people in the military to have to face [a situation] where they cant tell if someone approaching them is a friend or foe.

Editors note: Dr. Barnes does teaching and physician certification for Abbott Medical Optics (Abbott Park, Illinois) and STAAR Surgical (Monrovia, California).

Contact information

: scott.d.barnes.mil@mail.mil

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Refractive surgery and patient selection in the military by Ellen Stodola EyeWorld Senior Staff Writer

Careful consideration of military refractive surgery results by Maxine Lipner EyeWorld Senior Contributing Writer

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Tools for post-refractive surgery eyes by Louise Gagnon EyeWorld Contributing Writer

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