Abstract
Abstract: :
The Army Warfighter Refractive Eye Surgery Program (WRESP) was established to improve individual and force readiness, with the goal of reducing the limitations posed by corrective eyewear requirements of combat arms soldiers. Purpose: The objective of this study is to evaluate the Army WRESP program in terms of individual outcomes as well as impact on military readiness. Methods: Results were collected from monthly reports from the 7 WRESP laser centers to the Office of the Surgeon General from May 2000 through October 2003. Reports included the number and types of procedures, uncorrected visual acuity (UCVA), best spectacle–corrected visual acuity (BSCVA), and significant intraoperative or postoperative complications. In addition, questionnaires were administered to refractive surgery patients returning from deployments to southwest Asia in the global war on terrorism. Soldiers rated the impact of refractive surgery on their ability to perform select operational tasks, including night operations, weapons sighting, operations in extreme environmental conditions, and ability to use personal protective equipment. Soldiers also rated their contribution to unit mission as well overall individual readiness. Items were scored on a scale of 1 (much worse) to 5 (much better). Results. Between May 2000 and October 2003, 25,642 eyes of 16,091 service men and women were treated. PRK was performed in 59.6%, LASIK in 32.1%, and LASEK in 8.3%. Post–op UCVA was 20/20 in 85.6%, 20/25 in 91.8%, and 20/40 in 98.1% of eyes with at least 3 months follow–up. No eye lost greater than 1 line of BSCVA at 3 months or longer post–op. 90.2% of surveyed patients rated their overall individual readiness better or much better after surgery when compared to before surgery. Mean survey scores were: Overall readiness 4.69, Unit mission 4.69, Night operations 4.41, Weapons sighting 4.65, NBC equipment (gasmask) 4.61, Environmental conditions 4.10. Two individuals (3.9%) reported night operations worse or much worse after surgery, and 2 reported difficulty with harsh environmental conditions (heat, dust, sand, dry). No patient reported worse overall individual readiness after surgery. Conclusions. Soldiers treated under the Army WRESP program achieved excellent clinical outcomes in keeping with previously published standards. Surveys demonstrated a significant advantage to overall soldier readiness. Reports of night vision difficulties and dry eye are infrequent but merit further investigation to determine the impact on military operations.
Keywords: refractive surgery • clinical (human) or epidemiologic studies: outcomes/complications • quality of life