- The Washington Times - Tuesday, October 30, 2007

Darin Brown has a new outlook on life. Last month, the 44-year-old Germantown resident underwent LASIK eye surgery.

Before the surgery, Mr. Brown often found himself misplacing his glasses or turning his contacts inside out. The LASIK procedure has allowed him to see clearly without either of them.

“I can see so much better now,” Mr. Brown says. “There is a sharpness. When I’m driving at night, I can see farther. I saw a live deer about 100 yards ahead while driving. I might not have seen him before.”

The LASIK procedure has advanced so much that NASA approved the technology for U.S. astronauts last month. The LASIK, or laser-assisted in situ keratomileusis, technology also has been endorsed for U.S. military personnel.

When NASA approved LASIK for astronauts, it only confirmed what Dr. Mark Whitten says he already knew. “This is one more confirmation,” he says. “If NASA will allow astronauts to have this done to them, the person with everyday activities will be fine.”

Dr. Whitten is regional medical director of TLC Laser Eye Centers of the metro D.C. area. The company has offices in Rockville, Reston and McLean. Mr. Brown is his patient.

Athletes have known for years that LASIK is effective, Dr. Whitten says. He has lasered athletes such as golfer Tiger Woods.

“They look at all of this technology as performance enhancement,” Dr. Whitten says. “They see better. They perform better. For the average person, they might not notice all the little things the athletes see.”

The new all-laser LASIK procedure helped convince NASA of its safety and effectiveness, says Dr. Steve Schallhorn, chief medical director for Optical Express in Glasgow, Scotland. He also has a private practice in San Diego.

Although Dr. Schallhorn retired from the U.S. Navy in February, he previously served as its director of refractive surgery, where he conducted about 200 studies on laser vision correction. He also has been a consultant to NASA.

While conventional LASIK uses a hand-held microkeratome blade to create a corneal flap, the newer form of LASIK uses a femtosecond laser. The laser is computer guided and eliminates several of the possible complications associated with the mechanical blade.

“The femtosecond laser was a totally different way to make a flap,” Dr. Schallhorn says. “We found it resulted in a better flap.”

During the second step of the new procedure, wavefront guided technology maps a patient’s eye using another type of laser. Then it corrects the problems that are specific to the person’s eye, he says. In the conventional procedure, the laser essentially follows the general prescription used for measuring glasses or contact lenses. The new technology is about 25 times more precise, he says.

The combination of the femtosecond laser and wavefront-guided treatment to correct refractive error has produced optimal results, Dr. Schallhorn says. Advanced Medical Optics Inc., the Santa Ana, Calif., company that helped to pioneer the technology, calls it “Advanced CustomVue with IntraLase.” The procedure is about four years old.

While working for the Navy, Dr. Schallhorn also ran a series of studies that looked at the effects of the environment on LASIK patients. For instance, he tested the stability of the corneal flap in high altitudes and how it would respond during a wind blast or sudden ejection from an aircraft.

“We basically found that when you do a good LASIK procedure that there are no additional environmental risks other than what the general public should have,” Dr. Schallhorn says. “If LASIK is done properly and well-healed, an aviator faces no additional risks or issues.”

Astronauts and aviators have routinely had many problems with glasses and contacts, Dr. Schallhorn says. LASIK should make doing their jobs easier. .

“It’s fairly difficult to put an eye drop in your eye if there’s no gravity,” Dr. Schallhorn says.

Dr. Schallhorn, along with an expert panel, provided more than enough evidence that LASIK should be approved for astronauts, says Dr. Smith Johnston, a medical officer at NASA’s Johnson Space Center in Houston. Astronaut candidates must wait one year after having the surgery before they can apply for the astronaut program.

“If you can have a procedure that gives you 20/20 vision or better, that’s a win-win situation,” Dr. Johnston says. “It used to be the chance was 1 in 100 that you wouldn’t get a good outcome. It’s quite low now. They have the laser-guided machines that are so precise. We waited until the technology was perfected.”

Some people have likened laser vision surgery to a new medical weapons platform, says Dr. Stephen R. O’Connell, head of ophthalmology at the Naval Aerospace Medical Institute in Pensacola, Fla. He is a captain in the Navy’s medical corps.

Navy SEALS were one of the first groups interested in laser vision surgeries as a way to enhance military performance, he says. The Navy approved LASIK surgery for its aviators in December 2006. It is currently doing more research and fine tuning its regulations regarding the procedure.

“You can imagine landing a jet at night in the rain on a pitching carrier, as being perhaps one of the most visually demanding tasks,” Dr. O’Connell says. “We want our vision to be as good as possible, perfect.”

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