If your post doesn't have optical to do the process they will normally send you to the nearest place that does it. Like at Bliss they don't have it so they send people down to Hood (which is where my DH has it done when we where stationed there) to have it done. I know this because they had 6 people in his unit go with a group down there to get it done. Re-check with the optical people on post and see if going to another post to get it done is an option. Having it done while your on leave might be a bad idea, you will want to check with the doc about their follow up requirements to make sure that you will do all of the followups.

http://www.usaeyes.org/lasik/faq/lasek.htm

http://www.usaeyes.org/lasik/faq/epi-lasik.htm

I could keep copying info that I think is good from these, but there is so much good information. It talks about how after PRK, there was a problem with a little haziness sometimes…because of the injury to the eye, cells were sent there, and created a "haze." And with Lasik, there is a flap, but the cornea is "fooled" into thinking there is no injury, so it won't produce the haze.

Ask your opthalmologist lots of questions because that's his job, so don't feel bad about wanting to be clear about your options.

I found the articles below and hope that helps you with making your decision. From the way I understand it, nontraumatic flap injury doesn't happen often at all. But it sounds like, with your playing contact sports and possible violence on a daily basis (see the 2nd article), PRK may be a better choice since the epithelium grows back as a whole.

I did read one case report (I wish I could give you that link, but you need a password to get to it) where a 40 something woman had LASIK and an enhancement 5 years later. Six years after her enhancement, she had a traumatic eye injury with a tree branch. The corneal flap didn't detach, but got folded, necessitating a surgery with corneal sutures. Total time between initial LASIK and her injury: 11 years. She had a good visual outcome, but with increased astigmatism due to the sutures.

From the information you have given, and I had PRK…so I understand the healing process 100%…and your surgeon is recommending PRK approach versus the LASIK flap…I would listen to your surgeon and follow his advice, especially with a very active, potential eye injury, lifestyle.

Good luck!

With LASIK, a flap is created, 130-160 microns thick. Once this flap has been created, the laser is able to make the appropriate corrections as determined by preop measurements.

With PRK, there is no flap created. Instead, my surgeon used this little machine that reminded me of the rubber tooth polisher at the dentist (yah, funny, I know) to remove the corneal epithelium only, about 30-50 microns thick. Once that was done, the laser did its thing, a bandage contact lens was placed, and I went home to sleep.

Healing times are quite different between the two. With LASIK, patients typically have greatly improved vision in about 24 hours…much less pain and discomfort, and the cornea is able to heal a lot faster.

With PRK, I had good immediate vision in the office…it got cloudier and a lot more uncomfortable for about 4 days while the epithelium was growing back.

Think of it like this: you get a paper cut = LASIK…a scraped knee = PRK. A paper cut heals faster and is a bit less painful. Scraped knee heals more slowly and hurts more

When the excimer laser was first developed, all laser assisted surgery to reduce the need for corrective lenses was Photorefractive Keratectomy (PRK). The process of PRK is to remove the outermost layer of soft cells on the cornea (epithelium), reshape the surface of the cornea with the laser, and then wait for the epithelial cells to regenerate and cover the treatment area. Corneal epithelial cells are the fastest reproducing cells in the human body.

Early PRK was quite successful and a significant improvement over previous techniques, but it had some problems. Removal of epithelial cells causes a wound response that includes major discomfort and corneal haze if the laser needed to remove a lot of tissue to correct very bad eyesight.

A very clever eye surgeon realized that if the laser sculpting was done under a flap of corneal tissue and not at the surface, then the wound response would be different. Lasik is actually the combination of two surgical procedures. The first step of Lasik is to create a flap of corneal tissue and move it aside. The second step is to use an excimer laser to reshape the cornea. After ablation, the Lasik flap is repositioned over the treatment area. Lasik “fools” the eye into not knowing it has had surgery, so the wound response is muted. This is why Lasik can have almost instant vision recovery, virtually no pain, and virtually no chance of corneal haze.

There are a few important limitations to Lasik. One is corneal thickness. At least 250 microns of corneal tissue must remain untouched for a healthy eye to remain stable. The Lasik flap is about 100-160 microns thick, so the laser sculpting is starting that much deeper. Some people don’t have corneas thick enough to accommodate the Lasik flap.

The other problem with Lasik is the flap itself. Although Lasik flap related complications are relatively rare, they do occur. No Lasik flap means no possibility of a Lasik flap complication. No possibility is always better than a low probability.

Lasers and surgical techniques have improved over the past decade and the lasers are able to create very nuanced sculpting. Placing 100-160 microns of Lasik flap over a nuanced laser ablation loses some of the nuance. For these reasons, many doctors are returning to PRK as their primary choice for laser eye surgery.

Newer lasers and operative techniques have all but eliminated the chance of corneal haze with PRK.

In the long-term, the results from PRK will likely be equal to or slightly better than Lasik. In the short term you may experience discomfort and vision recovery will slower than Lasik. With PRK you can expect to have very poor vision for 1-3 days, “functional fuzzy” vision for about a week, and then vision quality will improve over the next few weeks and months.

1st Year Post LASIK: 88% success rates.
2nd Year Post LASIK: 65% success rates.
3rd Year Post LASIK: 50% success rates.
4th Year Post LASIK: 45% success rates.
5th Year Post LASIK: 40% success rates.
6th Year Post LASIK: 40% success rates.
7th+Year Post LASIK: Below 40%success rate.

Will you be one of the “lucky ones” that can last 10+ years without contacts or glasses?