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PRK surgery

 
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DAVELEIKAM(at)wi.rr.com
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PostPosted: Sun May 27, 2007 6:19 pm    Post subject: PRK surgery Reply with quote

Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?
I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

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neal.george(at)mchsi.com
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PostPosted: Sun May 27, 2007 7:23 pm    Post subject: PRK surgery Reply with quote

Dave -

I started wearing glasses at age 12, contacts at 16, hard lenses (to correct horrible astigmatism) at 17. I could read without my lenses, but couldn't see anything more than 3-ft away.

I had LASIK at 41 (almost three years ago). When I sat down on the table, I couldn't make out the logo on my shoes (and I'm usually the short guy in the room). Two minutes later, I was seeing 20/15. The left eye has drifted a little, but I expected it to - the astigmatism was really bad, and I didn't expect him to get it all. As the technology improves and if it gets any worse, I may have it tweaked in another five years or so.

It greatly improved my flying (and everything else). No more issues with dirt in my eyes, wind in my face, halos, foggy spots, fingerprints, focus shifting, slipped lenses, dropped lenses, etc, etc.

Best $4000 I ever spent. Don't pay any attention to the ads - do you really want to trust your sight to a bunch of folks who NEED to advertise to get your money (those would be .. trainees)? Find a doc who doesn't advertise, and who won't cut on just anybody.

After you do a little reading and a few interviews, I don't think you'll consider PRK.

Neal George
RV-7 N8ZG
Cowling!

Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying? I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

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pitts_pilot(at)bellsouth.
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PostPosted: Sun May 27, 2007 7:31 pm    Post subject: PRK surgery Reply with quote

I had Lasik done about 5 years ago. I was 20/400, correctable 20/20 with glasses, primarily for severe astigmatism. After my surgery I was 20/20 left eye and 20/35 in the right eye. Like most old farts, I wear glasses for reading. I have no issues with flying as I have a bifocal set of sunglasses with the bifocals set a little further out for the instrument panel. However, at night it's a different animal. Without glasses the full moon looks like an upside down micky mouse head, with the 'ears' being less bright copies of the moon. Street lights a block away have little daggers of light (about 3 principle ones) coming out from the light that disappear as the street light gets closer. None of this is a major negative, but shows that Lasik isn't perfect. I'd do it over again in a heartbeat.
Linn

Dave Leikam wrote:
[quote] Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?
I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

do not archive
Quote:

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LloydDR(at)wernerco.com
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PostPosted: Sun May 27, 2007 7:43 pm    Post subject: PRK surgery Reply with quote

Dave
Give me a call, I had PRK over 10 years ago and it was the best thing I ever did. I was worse than 20/400 and today I am at 20/20.
Dan
N289DT RV10E

From: owner-rv10-list-server(at)matronics.com [mailto:owner-rv10-list-server(at)matronics.com] On Behalf Of Dave Leikam
Sent: Sunday, May 27, 2007 11:19 PM
To: matronics
Subject: PRK surgery

Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?
I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

do not archive
[quote]

href="http://www.matronics.com/Navigator?RV10-List">http://www.matronics.com/Navigator?RV10-List
href="http://forums.matronics.com">http://forums.matronics.com

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Tim Olson



Joined: 25 Jan 2007
Posts: 2872

PostPosted: Sun May 27, 2007 7:51 pm    Post subject: PRK surgery Reply with quote

Dave, I had it done just over a year ago. Got LASIK with INTRALASE.
Was supposed to have lots of benefits over a knife sliced flap, and
have better results.

Tested at 20/15 the next day, month, and year. No dry eyes, no
issues. Couldn't be happier. The best almost 4 grand I ever
spent on my body. Make sure to do some searches on that specific
procedure, Intralase. It's pretty new, and has some added benefits.
The doc that did me said that after he had a few dozen more patients
he was going to use that exclusively because the results he was
seeing were better than the other, and it wasn't worth having
a 2 tiered price scheme if you could consistently get better results
with the intralase. It was one of those "custom" jobs, not just
the plain jane. No halos, no nuthin' to report to the negative.

Tim

Dave Leikam wrote:
Quote:
Have any of the pilots on this list had PRK surgery or LASIK and how do
you like the results for flying?
I know this is way off the building subject but I would like to put this
question out to a large number of pilots. If you feel it is not
appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

do not archive


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wayne.e(at)grandecom.net
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PostPosted: Mon May 28, 2007 4:37 am    Post subject: PRK surgery Reply with quote

Hello Dave,

I had LASIK surgery about three years ago and it has worked out great. I now have 20/15 vision. Because of my maturing age :>} they told me that if I had the surgery I would have to wear glasses to read, which didn't sound like a very good deal to me. I told the surgeon that and he said there is a procedure that could possible make it that I wouldn't need to wear glasses. It's called Mono Vision and he said that many people aren't able to adapt to it, but if I wasn't able to adapt they could complete the process and then I would wear reading glasses. The surgeon had Mono Vision for himself and I had that done and it worked out ok for me. My former partner had it and he wasn't able to adapt to it.

The mono vision is where the dominant eye is corrected for your long vision and the other eye is made for short vision. If someone is younger, I don't know for sure, but mid forty's or under, then they probably wouldn't have to worry about the Mono Vision option in that the eye is still somewhat flexible.

But anyway I've never been unhappy that I had it done. When I took my flight physical he said I had to wear glasses to fly because my non dominant eye can't see long distances. But if I understand it correctly I can apply to the FAA and then go up with an examiner to show I have depth perception with the surgery and they will wave the restriction, which I plan on doing.

Wayne Edgerton #40336






Time: 07:19:40 PM PST US From: "Dave Leikam" <DAVELEIKAM(at)wi.rr.com (DAVELEIKAM(at)wi.rr.com)> Subject: PRK surgery  
Have any of the pilots on this list had PRK surgery or LASIK and how do
you like the results for flying?
I know this is way off the building subject but I would like to put this
question out to a large number of pilots. If you feel it is not
appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

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seipel(at)seznam.cz
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PostPosted: Mon May 28, 2007 4:57 am    Post subject: PRK surgery Reply with quote

I'll chime in... I had PRK because that's what the military is/was
doing at the time. It worked great, and I love the results. That said,
healing was painful and I did have dry eyes for about six months. I'd
still do it again, although I'd think about the Intralase if I was doing
it now. At the time, getting it done for free was a big bonus.

PJ Seipel
RV-10 #40032

Dave Leikam wrote:
Quote:
Have any of the pilots on this list had PRK surgery or LASIK and how
do you like the results for flying?
I know this is way off the building subject but I would like to put
this question out to a large number of pilots. If you feel it is not
appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

do not archive
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apilot2(at)gmail.com
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PostPosted: Mon May 28, 2007 5:35 am    Post subject: PRK surgery Reply with quote

Just keep in mind that the FAA is very skeptical about monovision
because it was a contributing factor in an airline crash at La Guardia
awhile back. In that case I think it was the copilot flying using
monovision contact lenses with no specific approval and he apparently
didn't have sufficient depth perception and landed plane short of the
runway. (a very bad thing at that airport/runway)
Quote:
But anyway I've never been unhappy that I had it done. When I took my flight physical he said I had to wear glasses to fly because my non dominant eye can't see long distances. But if I understand it correctly I can apply to the FAA and then go up with an examiner to show I have depth perception with the surgery and they will wave the restriction, which I plan on doing.

Wayne Edgerton #40336



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dc71(at)netspace.net.au
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PostPosted: Mon May 28, 2007 7:45 am    Post subject: PRK surgery Reply with quote

As a practicing ophthalmologist, a pilot, and RV10 builder, I'd like to add a few data points to the LASIK/PRK discussion.
Firstly, the procedure is classified as a cosmetic procedure - ie surgery on a previously healthy body part. Even the medical indemnity insurance companies classify LASIK/PRK surgeons in the same category as cosmetic plastic surgeons.

The concept of best corrected visual acuity (BCVA) needs to be brought up - the best achievable vision with spectacle correction. While people do see an amazing increase in uncorrected visual acuity (UCVA), the fact is that BCVA stays the same or drops one line. In addition, there is a definite decrease in contrast sensitivity after the procedure (think IFR approach to minima in haze/smoke/cloud). Other symptoms like glare and haloes at night do occur in a small but significant proportion of patients. These facts are all well supported by multiple studies. What this means is that your best potential vision deceases slightly after surgery.

Thirdly, the lack of long-term followup studies, particularly for LASIK. The eye can be considered as a floppy bag pumped up with fluid to maintain it's shape. The cornea is 500 microns thick on average, and stays generally the same shape for a lifetime, resisting deformation by intraocular pressure. LASIK involves cutting a flap (mechanically or with laser) of 120-160 microns thick, then removing up to 100 microns with the excimer laser. This can leave only 250 microns or so to last the rest of the patient's lifetime. Some of the earlier attempts with LASIK where even more corneal tissue was removed resulted in gradual bulging forward of the cornea (iatrogenic keretectasia) several years later. These unfortunate patients needed corneal transplantation. PRK has fewer of these biomechanical concerns as less corneal tissue is removed.

Surgical risk needs to be brought up - while rare, it is possible to have a complication which can permanently damage vision post-operatively. 

The flap created by LASIK also never fully heals. It is very easy to lift a flap years after the initial procedure with a blunt instrument. There was a case described of a man who lost his flap during a game of basketball 4 years after LASIK when another player's fingernail grazed his eye at the wrong angle. The military does not use LASIK for combat pilots/paratroopers etc, because the flaps swell and distort at high altitude(>15,000ft), low humidity and low oxygen.

Having said all of this, the procedure has very good results (although not perfect). The outcome can be a life-changing event for someone previously dependent on spectacles or contact lenses for every aspect of their daily life. I hope that by bringing up these points, anyone considering the procedure researches the issues thoroughly and comes to a fully informed decision.

Indran
On 28/05/2007, at 11:19 AM, Dave Leikam wrote:
Quote:
Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?
I know this is way off the building subject but I would like to put this question out to a large number of pilots.  If you feel it is not appropriate for this list, just let it die.
 
Thanks.
 
Dave Leikam
40496
 
do not archive
Quote:
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Tim Olson



Joined: 25 Jan 2007
Posts: 2872

PostPosted: Mon May 28, 2007 8:17 am    Post subject: PRK surgery Reply with quote

Indran gave some excellent info there. My doc did warn me about
the possibilities, and there are people who have things go wrong.
Even when they quote 95% success rates, that's still quite a few
people left with issues.

Just on the below note though... From what I was told, the
Intralase procedure I mentioned is an improvement from the blade
just because of the flap issue. Instead of cutting the flap, they
use a laser to explode little bubbles uniformly at a certain depth,
creating a flap that can be lifted. It's this non-razor-cut flap
that is supposed to help it heal quicker and firmer to the cornea.
They called it kind of a "velcro flap" effect.

I have absolutely zero first-hand medical knowledge that qualifies
me to give any more than my personal results, but basically, I
had been in twice for lasik and decided against it after further
contemplation, until I got to learn about custom correction with
Intralase and then took the plunge.

Sorry to be going on off-topic, but Indran's info was fantastic
and the thread will probably die off soon anyway.

Tim
do not archive

Indran Chelvanayagam wrote:
Quote:

The flap created by LASIK also never fully heals. It is very easy to
lift a flap years after the initial procedure with a blunt instrument.
There was a case described of a man who lost his flap during a game of
basketball 4 years after LASIK when another player's fingernail grazed
his eye at the wrong angle. The military does not use LASIK for combat
pilots/paratroopers etc, because the flaps swell and distort at high
altitude(>15,000ft), low humidity and low oxygen.



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jim(at)CombsFive.Com
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PostPosted: Mon May 28, 2007 8:46 am    Post subject: PRK surgery Reply with quote

I had Lasik done (about 12 years ago). I went from having to wear corrective lenses for far vision to using reading glasses.

Pros - My age (52) would require reading glasses anyway but I get by with cheap Walmart glasses (multiple sets) left in places where I use them, home office, car, airplane. My distant vision is now 20/15 and I can use non prescription sunglasses.

cons - Yes I did have night vision halo's for about 8 months after the surgery. i do notice some problems right at twilight and dim lighting conditions. Nothing major.

My medical still requires that I carry glasses, so no difference there.

As a point of reference, I think the Naval Academy is now doing all midshipmen in an effort to get more potential pilot candidates. I will have to check with my daughter on that.

Jim C
40192
Finishing Kit.

============================================================
From: "Dave Leikam" <DAVELEIKAM(at)wi.rr.com>
Date: 2007/05/27 Sun PM 11:19:12 EDT
To: "matronics" <rv10-list(at)matronics.com>
Subject: PRK surgery

Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?
I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.

Thanks.

Dave Leikam
40496

do not archive
============================================================


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AV8ORJWC



Joined: 13 Jul 2006
Posts: 1149
Location: Aurora, Oregon "Home of VANS"

PostPosted: Mon May 28, 2007 3:16 pm    Post subject: PRK surgery Reply with quote

Thank you and what a valuable post. You are confirming with clarity much of which I have heard muddled for the last five years.

John C.


From: owner-rv10-list-server(at)matronics.com [mailto:owner-rv10-list-server(at)matronics.com] On Behalf Of Indran Chelvanayagam
Sent: Monday, May 28, 2007 8:45 AM
To: rv10-list(at)matronics.com
Subject: Re: PRK surgery


As a practicing ophthalmologist, a pilot, and RV10 builder, I'd like to add a few data points to the LASIK/PRK discussion.


Firstly, the procedure is classified as a cosmetic procedure - ie surgery on a previously healthy body part. Even the medical indemnity insurance companies classify LASIK/PRK surgeons in the same category as cosmetic plastic surgeons.



The concept of best corrected visual acuity (BCVA) needs to be brought up - the best achievable vision with spectacle correction. While people do see an amazing increase in uncorrected visual acuity (UCVA), the fact is that BCVA stays the same or drops one line. In addition, there is a definite decrease in contrast sensitivity after the procedure (think IFR approach to minima in haze/smoke/cloud). Other symptoms like glare and haloes at night do occur in a small but significant proportion of patients. These facts are all well supported by multiple studies. What this means is that your best potential vision deceases slightly after surgery.



Thirdly, the lack of long-term followup studies, particularly for LASIK. The eye can be considered as a floppy bag pumped up with fluid to maintain it's shape. The cornea is 500 microns thick on average, and stays generally the same shape for a lifetime, resisting deformation by intraocular pressure. LASIK involves cutting a flap (mechanically or with laser) of 120-160 microns thick, then removing up to 100 microns with the excimer laser. This can leave only 250 microns or so to last the rest of the patient's lifetime. Some of the earlier attempts with LASIK where even more corneal tissue was removed resulted in gradual bulging forward of the cornea (iatrogenic keretectasia) several years later. These unfortunate patients needed corneal transplantation. PRK has fewer of these biomechanical concerns as less corneal tissue is removed.



Surgical risk needs to be brought up - while rare, it is possible to have a complication which can permanently damage vision post-operatively.



The flap created by LASIK also never fully heals. It is very easy to lift a flap years after the initial procedure with a blunt instrument. There was a case described of a man who lost his flap during a game of basketball 4 years after LASIK when another player's fingernail grazed his eye at the wrong angle. The military does not use LASIK for combat pilots/paratroopers etc, because the flaps swell and distort at high altitude(>15,000ft), low humidity and low oxygen.



Having said all of this, the procedure has very good results (although not perfect). The outcome can be a life-changing event for someone previously dependent on spectacles or contact lenses for every aspect of their daily life. I hope that by bringing up these points, anyone considering the procedure researches the issues thoroughly and comes to a fully informed decision.



Indran




On 28/05/2007, at 11:19 AM, Dave Leikam wrote:




Have any of the pilots on this list had PRK surgery or LASIK and how do you like the results for flying?

I know this is way off the building subject but I would like to put this question out to a large number of pilots. If you feel it is not appropriate for this list, just let it die.



Thanks.



Dave Leikam

40496



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DAVELEIKAM(at)wi.rr.com
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PostPosted: Mon May 28, 2007 6:59 pm    Post subject: PRK surgery Reply with quote

Thanks for all the info. You guys are great! I have been on the fence
about the surgery for a long time. My wife had LASIK done and says the only
thing she regrets is that she waited so long. I'm 41 and see 20/15 with
contacts. It's really hard to justify fixing something which doesn't seem
broke. I have a mapping appointment on Thursday. Thanks again.

Dave Leikam
40496
QB wings

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PostPosted: Tue May 29, 2007 8:07 am    Post subject: PRK surgery Reply with quote

Dave

I had LASIK surgery a few months back, just before going to SnF. The correction is fantastic for clarity in the sky however the related loss of close up vision has been a bit challenging. When I first started back flying about a week after the procedure I needed to have dark sun glasses on the top and small magnifiers below hanging on my nose. I found a vendor a SnF that offered sun glasses with the 1.5 magnifier on the bottom and they now do the job for general flying. I still need the small clear ones for check lists, pre-flight and too look down at charts, etc. If you get LASIK or PRK I can not stress enough the use of eye drops, it is the best way to heal and restore your vision.

Paul Grimstad
RV10 40450
Portland, Or.

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