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Old 04-15-2011 | 10:19 AM
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From AFI48-123 Medical Examinations and Standards

(RS means Refractive Surgery)

"12.1.8. For the purpose of this guidance RS authorized for AASD only includes the following: Note: See Aircrew waiver guide for specific clinical guidelines.
12.1.8.1. Advanced Surface Ablation (ASA) procedures.
12.1.8.1.1. PRK.
12.1.8.1.2. LASEK.
12.1.8.1.3. Wave-Front Guided Photorefractive Keratectomy (WFG-PRK).
12.1.8.1.4. Epi-LASIK.
12.1.8.2. Intra-Stromal Ablation (ISA) procedures
12.1.8.2.1. Standard LASIK and its variants.
12.1.8.2.1.1. DELETED
12.1.8.2.2. Wave-Front Guided Laser In-Situ Keratomileusis (WFG-LASIK) -
―custom ablation.
12.1.8.2.3. Technological advances of the basic LASIK procedure, such as
femtosecond technology, ―all laser LASIK."


And from the USAF Waiver Guide:

"The USAF-RS Program permits both advanced surface ablation (ASA) and intra-stromal ablation (ISA) procedures in eligible AF active duty and AF Reserve Component (ARC) members. ASA approved procedures include photorefractive keratectomy (PRK), laser in-situ epithelial keratomileusis (LASEK), epi-LASIK and wave-front guided photorefractive keratectomy (WFGPRK). ISA approved procedures include standard laser in-situ keratomileusis (LASIK) and its variants, wave-front guided laser in-situ keratomileusis (WFG-LASIK), and technological advances in the basic LASIK procedure, such as femtosecond technology. The incorporation of WFG treatments into RS is expected to improve visual outcomes, particularly in low light and low contrast situations. For this waiver guide unless specifically specified, PRK will be used in place of ASA and LASIK in place of ISA."

Continuing on, it reads:
"For AASD and AASD applicants, ASA is the preferred RS procedure recommended by the Aeromedical Consultation Service (ACS) and AF/SG RS consultant. Clinical criteria required before permission to proceed is granted in AASD personnel and applicants to AASD for waiver:
A. Age 21 or older.
B. Refractive error limits do not exceed those listed in Table 1. (see AFPAM 48-133 for cycloplegic protocol).
C. Show demonstrated refractive stability with no more than 0.50 diopter shift in manifest sphere or cylinder power between two or more refractions (one refraction current with application data and the other at least one year older).
D. Normal corneal topography (CT) – no evidence of abnormal corneal surface topography (including but not limited to): corneal irregularity, abnormal videokeratography, keratoconus, and/or “topographical pattern suggestive of keratoconus” (TPSK) in either eye.
E. No history or evidence of (including but not limited to): active ophthalmic disease, corneal neovascularization within 1 mm of intended ablation zone, central crystalline lens opacifications (i.e. post subcapsular cataracts), severe dry eyes, keratoconjunctivitis sicca, uveitis, keratitis,
excessive pupil enlargement, glaucoma, predisposing disorder to glaucoma development (i.e. pigment dispersion syndrome with IOP greater than 21 mm Hg) or retinal pathology.
F. Not currently pregnant or actively nursing--must be greater than 6 months post-partum or greater than 6 months after discontinuing nursing.
G. Not using concurrent topical or systemic medication which may impair healing (including but not limited to): corticosteroids, antimetabolites, isotretinoin (Accutane®), amiodarone hydrochloride (Cordarone®), and/or sumatriptan (Imitrex®).
F. No history of medical conditions which, in the judgment of the treating corneal refractive surgeon may impair healing (including but not limited to): collagen vascular disease, autoimmune disease, immunodeficiency disease, active or history of ocular herpes zoster or simplex, endocrine disorders (e.g. thyroid disorders and diabetes)."


In short, pretty much all eye surgeries are approved for applicants and current rated aviators, however there are a few that are not approved. Referencing line "12.1.8.2.1. Standard LASIK and its variants." makes it sound like you are okay if LASIK was what you had done. Contact a squadron Flight Surgeon and he/she will be able to tell you for sure. The flight surgeon from the unit that I applied to was able to give me the proper guidance to make an informed decision, as I'm going under the knife for WFG-PRK in two weeks for the purpose of pursuing a guard pilot slot. From reading these documents, it seems the Air Force believes that WFG-PRK achieves the best results and more reliably than other types of refractive surgery.

Further, just understand that having ANY approved surgery will still require a waiver before you can be given the stamp of approval for flight training. (Not a waiver to be allowed to have the surgery, but a waiver for the fact the you have had the surgery already).

Both of these documents are easy to obtain via a two second google search: "USAF Waiver Guide" and "AFI48-123".



Good luck!
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