Laser refractive surgery in the United States Navy.
OBJECTIVE
The aim of this article is to highlight the numerous contributions the US Navy has made to the field of laser refractive surgery. It summarizes and draws together published papers, national meeting presentations, and unpublished data of clinical and laboratory studies involving the excimer laser and the laser-assisted in-situ keratomileusis (LASIK) flap.


RESULTS
Photorefractive keratectomy (PRK) is the most widely performed refractive procedure in the US Navy, but this trend is slowly changing as femtosecond laser-assisted LASIK becomes more widely performed. Based on the results of recent studies, PRK is approved for designated Naval aviators and flight officers; post-PRK students are now allowed into flight training. Wavefront-guided PRK and LASIK are more predictable and provided better results than conventional PRK and LASIK. Femtosecond laser-assisted LASIK is now a waiverable procedure for US military personnel and US Astronauts (excluding Naval aviators, as of this writing).


CONCLUSIONS
Since its personnel must meet strict visual requirements to accomplish their mission in a variety of environments, the US Navy places particular emphasis on safety and quality of vision after laser refractive surgery. The US Navy has been evaluating the safety and efficacy of laser refractive surgery since 1993 and will continue to do so.
Wilmer Ophthalmological Institute, Baltimore, Maryland, USA. fatvette@yahoo.com
Philip F
PF
Stanley
David J
DJ
Tanzer
Steven C
SC
Schallhorn
D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000639:trends*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008889:Military Personnel; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009326:Naval Medicine; D018903:Photorefractive Keratectomy / Q000639:trends*; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014481:United States