Blame it on PRK?

[blazenmadison]

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In an article about the NFL star that went to Iraq and was killed by friendly fire.... http://www.usatoday.com/news/nation/2006-11-09-tillman-probe_x.htm?csp=34

"One of the four shooters, Staff Sgt. Trevor Alders, had recently had PRK laser eye surgery. He said although he could see two sets of hands "straight up," his vision was "hazy." In the absence of "friendly identifying signals," he assumed Tillman and an allied Afghan who also was killed were enemy."

Is this a good excuse?
I am not an OD so would this be a common symptom of PRK? If so, would the military be likely to enact a ban on future refractive surgeries?

 

[Opii]

Military services use PRK on soldiers over Lasik to avoid the flap cut into a patient's eye during Lasik. In PRK, the laser burns through the surface layers of the cornea, while the surgery can also correct vision to 20/20 or better, it leaves an abrasion on the eyes of the patient, healing may take about four days but halos, blur, can take much longer to improve. It is completly possible this sergeant made an honest mistake. This case is still under investigation. All the same it is a shame it happened.

 

[PBEA]

In an article about the NFL star that went to Iraq and was killed by friendly fire.... http://www.usatoday.com/news/nation/2006-11-09-tillman-probe_x.htm?csp=34

"One of the four shooters, Staff Sgt. Trevor Alders, had recently had PRK laser eye surgery. He said although he could see two sets of hands "straight up," his vision was "hazy." In the absence of "friendly identifying signals," he assumed Tillman and an allied Afghan who also was killed were enemy."

Is this a good excuse?
I am not an OD so would this be a common symptom of PRK? If so, would the military be likely to enact a ban on future refractive surgeries?

Wow, thats brutal, I was not aware of this aspect of Tillmans death. What a shame. Just to add to Opiis response, PRK or Lasik can both have poor visual outcomes. While IMHO, these are seemingly "glossed" over in the literature, do not expect/assume that every refractive procedure will turn out the way you would like. I would like to look at that guys cornea first, but it is entirely possible that he is telling the truth. Although I probably would have to work around a little "functional" vision loss, and thats never a fun exam.

 

[4Eyes]

Without this thread, I would have missed out on 5 extra credit points today. Thanks blazen! 🙂

 

[orangezero]

I'm pretty sure the military uses PRK (instead of lasik) because the outcomes with PRK generally provide increased contrast sensitivity, and perhaps a small increase in VA over lasik.

The reasoning was, lasik is good enough for regular patients, but if someone is flying a $10million dollar machine we'd better not reduce his contrast sensitivity (or at least as much).

 

[JMK2005]

Check out the article in this month's Ophthlamology

Evidence for Superior Efficacy and Safety of LASIK over Photorefractive Keratectomy for Correction of Myopia
Ophthalmology, Volume 113, Issue 11, November 2006, Pages 1897-1908
Alex J. Shortt, Catey Bunce and Bruce D.S. Allan

It seems that it is still to be determined which is better...

 

[orangezero]

It seems that it is still to be determined which is better...

Thanks for the article.

I think thats a very good point.

 

[Caffeinated]

First, a point of clarification on military refractive surgery from the Army perspective. The Army uses both LASIK and PRK for active duty soldiers, and the long-term data suggests that both procedures are equal in final outcomes. However, PRK is the only option for certain positions (e.g., Special Operations) due to concerns about flap stability.

The environment in which the Tillman incident occurred had many factors that could have contributed to this incident. Among them, taking rounds from enemy in an elevated position and the angle of the sun causing disabling glare (even for the non-refractive surgery patients). Also, Tillman was not alone in the incident--he was with several other soldiers who were providing suppressive fire when he was mistaken for enemy.

Lastly, keep in mind that the "fog of war" is probably the major culprit here. Taking a barage of rounds from an enemy you cannot see has a way of messing with your head. Could PRK have contributed? Sure, it is possible. But had this soldier NOT had PRK, there is a possiblity that his spectacles could have also caused disabling glare. Furthermore, it is possible that he may have not been wearing spectacles during this incident due to sweat, interference with other protective equipment, or having them knocked off during the frenzy of combat. So before indicting PRK, keep in mind that the military does not use refractive surgery as a cosmetic procedure--there are substantial operation considerations.