Preparing for Your Pre-Op Consultation

How to Prepare

• Before refractive eye surgery, the patient must have a signed commander’s letter permitting refractive surgery.
• Patients are asked to bring or wear their eyeglasses (or prescriptions) that are at least one year old.
• Patients must completely discontinue contact lens wear prior to the evaluation: for soft contact lenses three weeks prior, and for gas permeable lenses four weeks. Failure to do so may delay surgery or could prevent the patient from having surgery.

The pre-operative consultation with complete dilated eye exam by our optometrist usually takes about four hours. Patients need to attend a group briefing or individual counseling with an ophthalmologist who reviews the patient’s chart. This appointment generally lasts about two hours and 30 minutes, and is scheduled on a day prior to the surgery day. Additional or repeat tests may be performed to ensure safe surgery.

NOTE: Patients requesting refractive surgery are required to avoid the intranasal vaccine FluMist 30 days prior to surgery and 30 days after surgery. The flu shot is acceptable anytime before or after refractive surgery.

Surgery, Follow-Up, and Deployment

It is crucial for service members and authorizing commanders to be aware of the requirements surrounding refractive surgery in order to plan for training and deployment:

• PRK, LASIK, or SMILE generally lasts 10 to 20 minutes per patient, but patients may be in the clinic the entire morning or afternoon, depending on the number of patients being treated that day.
• Post-op appointments are scheduled for one day, one week, and one, three, six and 12 months after LASIK or SMILE.
• Post-op appointments are scheduled for four days and one, three, six and 12 months after PRK.
• After LASIK or SMILE, patients are placed on a one-month non-deployable profile.
• After PRK, patients are placed on a three-month non-deployable profile.

Profiles are given to optimize healing and minimize injury to the eyes after surgery, and 96 hours of unit convalescent leave is given after PRK, LASIK, or SMILE. We expect units to adhere to the profile’s restrictions. For 30 days after surgery, service members should not live in tents, work in sunny, dusty or windy environments, do organized physical training, swim, wear protective masks or face paint, fire weapons or drive military vehicles. Also, when in sunny or bright environments, service members must wear sunglasses outdoors at all times for one year after surgery to minimize the risk of corneal scarring and hazy vision.

After PRK most patients require 90 days of follow-up prior to deployment, but occasionally service members may be released after 60 days if their treatment was low and healing looks good. The post-op appointments are necessary to ensure refractive stability and prevent deploying service members who are having rare complications. Again, most patients heal by the time the profile expires, but commanders must understand rare complications or slow healers exist, and these outliers may require more frequent or longer follow-up.

Special Travel Considerations

The processing of laser candidates not stationed near the WRESP-RC is slightly different to reduce the number of times traveling to the center. Ideally, a coordinator should be assigned at each base to help facilitate candidacy and pre-operative appointments.

Applicants are pre-screened for eligibility at their local base and follow-up care to be pre-established (Managed Care Agreement) as part of their application. Local applicants do not need to complete a Managed Care Agreement if care is completed at the WRESP-RC.

Group counseling and evaluations are granted on specific dates where maximum clinical attention can be provided to expedite a complete ophthalmologic examination and specialized testing can be done. A selection of surgical dates is presented to help the applicant with planning for their return (lodging, etc.) if they are considered a go for surgery.

After the pre-operative consultation, patients can schedule counseling, surgery, and up to one month post-operative appointments.

Restrictions

Any Army applicant, regardless of their job or specialty can get PRK, LASIK or SMILE surgery. Aviators considering refractive surgery procedure must coordinate their treatment and application of waiver through their unit flight surgeon.

Navy, Air Force, and Marine Corps policies may differ slightly from the Army’s refractive surgery policies, so those members should contact their nearest same-service refractive surgery center to answer service-specific questions, but Alexander T. Augusta Military Medical Center’s Refractive Surgery Center can evaluate all service members.