PRK and Special Tactics Operators

NOTE: All PRK related information can be viewed and downloaded here:

USAF Medical Service "Warrior Eyes" PRK Information Site

Additional Information for Special Duty Applicants

Additional information and downloads specifically regarding PJ/CCT PRK information

Robert C. Allen, DO, FACEP
Lt Col, USAF MC CFS
Group Surgeon
720th Special Tactics Group
10 October, 2000

The Surgeon General of the Air Force has approved the USAF Aviation and Special Duty Photoreactive Keratectomy (PRK) Waiver and Surveillance Program (USAF SG Policy # 00-05). What does this mean? It means that ST Operators can get PRK (a specific type of laser eye surgery) done to correct their vision. This paper will give you an idea of what the requirements are, and the procedures that must be followed in order to obtain this surgery.

A) PRK is an optional surgical procedure that can in many cases, correct near and distant visual acuity to the point where the patient no longer needs glasses. Note that ONLY PRK is approved at this time: LASIK and Radial Keratotomy (two other kinds of vision-correction surgery) are NOT approved under this program. LASIK may be approved in the future, research is ongoing. Radial Keratotomy, the older form of vision correction surgery will likely never be approved.

B) There is a risk of bad outcome in this surgery (estimated at less than 1 percent). If there is a bad outcome and your vision drops below relevant vision standards, then you could be medically disqualified from CCT/PJ duty. Not all forms of defective visual acuity can be corrected by PRK: Each case must be considered individually

C) There will be a period of approximately 6-8 weeks of DNIF following surgery, and approximately 4 months of no-mobility status following surgery.

D) The Squadron Commander must give permission for any member to have PRK.

E) Pilots are only allowed to have the procedure done at Wilford Hall USAF Medical Center. Non-pilots and special duty personnel (ie us) may have the procedure done at Wilford Hall or any other designated Refractive Surgery for the Warfighter Center in the DoD. Note that for Active Duty ST Operator personnel it is NOT an option to have this done on your own, on the economy.

F) The unit must fund the TDY to the hospital where the procedure will be done. TDY for any follow-up care needed is also the responsibility of the unit.

G) Frequent follow-up evaluations are required. Many of these can be done in the local area if the Optometrist or Ophthalmologist has had specific training in doing this type of follow-up. Follow ups must be done at 1,2,3,4,6,12 and 24 months. These are mandatory follow-up evaluations. Missing a follow-up appointment results in automatic DNIF until the follow-up is accomplished. For pilots the pre-operative eye exam, 12-month and 24 month follow-up must be done at the Aeromedical Consultation Service, Brooks AFB. There is a strong possibility that Special Duty personnel (us) will have to have the 12 month and 24 month follow-up done at Brooks AFB.

H) Waiver after PRK may be considered as soon as 4 weeks after surgery, if specific conditions are met. Local waiver is authorized, with final waiver authority at MAJCOM level (HQ AFSOC/SGP in our case). Initial waivers are for 1 year, subsequent renewal can be for 2-3 years at MAJCOM discretion. Indefinite waivers are specifically NOT authorized.

I) PRK done on fliers or Special Duty personnel will be entered into a PRK Registry at the School of Aerospace Medicine at Brooks AFB.

J) For CCT/PJ applicants: PRK can be waivered, however all of the standards noted in the Air Force PRK Waiver Program must be met. If PRK was done in a civilian hospital or other setting, the applicant is responsible for obtaining all required documentation from the surgeon. AETC/SG is the designated waiver authority for CCT/PJ applicants. PRK must have been done a minimum of 12 months prior to accession (i.e. if you have PRK done today, AETC will consider a waiver no earlier than October 2001).

K) DoD Refractive Surgery for the Warfighter Centers are being established at several DoD facilities, including Wilford Hall USAF Medical Center, Naval Medical Center San Diego, Naval Medical Center Portsmouth, Madagan Army Medical Center and Womack Army Medical Center. Not all of these are on-line at this time. More centers may be designated in the future.

L) ST Operators who would like to have PRK must do the following: 1. Obtain permission of the Squadron Commander 2. Local screening by flight surgeon and Optometrist or Ophthalmologist to verify that the clinical criteria are met. 3. The package is then sent to Aeromedical Consultation Service, School of Aerospace Medicine, Brooks AFB for clearance and permission to proceed. 4. Member makes appointment for surgery at Wilford Hall or other Refractive Surgery for the Warfighter Center. 5. Comply with all follow-up visits. 6. Waiver request, via Aeromedical Summary, is generated by the local flight surgeon when clinically indicated. Waiver can be granted while using steroid eye drops (required for up to 4 months after surgery), however the Operator must be in non-mobility status while using steroid eye drops.

M) For further information, reference AF/SG Policy # 00-05. I strongly recommend you read this policy and discuss it with your local flight surgeon before initiating a request for surgery.

N) I will not advocate or discourage any personnel from seeking this surgery. I am painfully aware that glasses and contacts can be a nuisance at best, and an operational hazard at worst. However, unlike the ST immunization policy, where nobody gets a new type of shot until I take it first, I will not be getting PRK surgery.