Lasik and getting back in the air

[GraficO 0]

Calling Dr. Shugar...Calling Dr. Shugar....

I had Lasik done on both eyes on December 18th and I am just absolutely astonished in how well I can see... trouble is that the doc said not to skydive for 2 weeks and the surgeon said 3 months.

While I would normally err on the side of the surgeon... is he just being overly cautious with a 3 month stand-off from jumping?

Any professional/medical advice would be helpful... from a skydiving point of view.

Thanks ahead of time.

GraficO

GraficO

"A Mind is a terrible thing to taste."

[Nuke 0]

Not doing any skydiving anymore (knees) but since I'm diving I having the same problems. I'm planning LASIK 27/1 and had to postpone a trip to the Red Sea because of it.

My surgeon says it takes 1-3 months for the eye to fully heal, it's individual, and he doesn't recommend me doing any diving before that. You will just have to check your eyes on a regular intervall if you want to be safe and get airbourne as soon as possible.

There has been very little research done in this area as I understand it and they don't know what might happen. Some of the surgeons I have been talking to wasn't even aware of the risks......

/Markus

[kelpdiver 2]

Quote

I had Lasik done on both eyes on December 18th and I am just absolutely astonished in how well I can see... trouble is that the doc said not to skydive for 2 weeks and the surgeon said 3 months.

While I would normally err on the side of the surgeon... is he just being overly cautious with a 3 month stand-off from jumping?

Did he give any explanation for it? If not, then the answer is yes. DAN's standard rec for scuba is min of 2 weeks, recommendation of 4 weeks, and diving poses a much greater risk than skydiving due to the pressure concerns. And even then many back in within days.

The one possible rationale that comes to mind is the historic high altitude issues seen with RK - climbers on the big (ie, 18k+) mountain climbs have suffered temporary blindness. But that procedure is caveman like compared to LASIK.

I guess you want to find skydiving Lasik surgeons for a better answer. My unqualified one says go with the 4 week period they suggest for any rough outdoor activities.

[D22369 0]

I had Lasik done on both eyes on December 18th and I am just absolutely astonished in how well I can see ***

Pretty cool huh
I had lasik done in 2001 and took a month off (doctor said 6 weeks)

the explanation I was given was that the little flap that they cut away and replace(the skin of they eye) -heals relatively fast but be susceptable to damage caused by sudden and strong gusts of wind (like if your goggles blew off)
I think they are being very cautious in the time table to return to skydiving, three months seems excessive..... but I aint a doc....

Roy

They say I suffer from insanity.... But I actually enjoy it.

[dragon2 2]

My lasik doc used to fly stunt aircraft. He said to wait 2 months before jumping, so I listened! BTW for stuntflying, make that 3 to 4 months...

ciel bleu,
Saskia

[airtwardo 7]

Quote

My lasik doc used to fly stunt aircraft. He said to wait 2 months before jumping, so I listened! BTW for stuntflying, make that 3 to 4 months...

Quote

Yup!
That's what my Doc said...10 years ago..
because of both opening shock
and the possible damage wind might do
(goggle slip)

He did a lot of fighter pilots,
and the G load was his main concern...

He knew what he was talking about..(kinda)
he told ME opening shock on a reserve could
go 10G's or more...

and the squishy parts of the eye
might come out of the areas 'cut'...

~ If you choke a Smurf, what color does it turn? ~

[BigM 2]

I put off Lasik because I didn't want to deal with the down time. A dislocated hip provided me with some unplanned and non-optional down time. After Lasik, I jumped 6 weeks later with the Doc's blessing, using a full faced helmet for a few more weeks. Bottom line, just like skydiving- it is YOUR body... you are ultimitely responsible.

Blue 111-
Jeff

"When I die, I want to go like my grandmother, who died peacefully in her sleep. Not screaming like all the passengers in her car."

[peregrinerose 0]

I am an eye doc.

To the person who said that scuba is more dangerous than skydiving on a lasik patient, it is not. There were cases of mountain climbers who had PRK (an earlier form of refractive surgery) who had severe corneal decompensation during their climb. The medical term isn't important, just know that this is very very bad.

Corneas take months to mostly heal, may take years to completely heal. There is good reason for this. If you skin your knee, you get a scab for protection and rich blood supply to deliver the raw materials needed to heal wounds. On a cornea, there is no blood supply, so no scab, no nutrients or raw materials provided to the site of trauma for quick healing. That is why it takes so very long to heal.

After lasik, you have a cornea that is thinner than it used to be, plus a flap that was flipped back completely from the rest of the cornea. This flap needs to be very reattached before changes in altitude should be even attempted. The reduced oxygen pressure can make it more difficult for the pumps in the cornea to keep the excess water out, this can cause corneal swelling, which increase risks of problems.

You only have one set of eyes. Which is more important, playing it conservatively and waiting until your corneas have a chance to fully heal, or skydiving knowing that you increase your chance of problems that can cause permanent vision loss? Even though the side effects from this are not frequent, why risk it just hoping that you don't hit that particular lottery?

Jen Galbraith, OD, MS

Do or do not, there is no try -Yoda

[kelpdiver 2]

Quote

To the person who said that scuba is more dangerous than skydiving on a lasik patient, it is not. There were cases of mountain climbers who had PRK (an earlier form of refractive surgery) who had severe corneal decompensation during their climb. The medical term isn't important, just know that this is very very bad.

What is the cause, Jen? Decreased oxygen, or reduced pressure? I was aware of incidents, but thought they were RK, not PPK. (err...which is PRK?) And very high up - well into the 20s I thought for cases on Everest (Into Thin Air).

Diving subjects the eyes to pressure up to 5 atmospheres, and those who don't equalize can get a nasty mask squeeze injury. But the danger of losing the goggles in freefall does seem bad - you wouldn't want to do it with sunglasses.

[Ron 10]

I now folks that jumped the next day.

I was told two weeks, and I waited two weeks.

you have one set of eyes...Why not do what the Doc says?

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[peregrinerose 0]

Increased pressure with scuba, the opposite with altitude. Wind isn't great. Increased dryness from dryer air in plane to altitude on an eye that is already dry from surgery so needs as much lube as possible to keep a flap from getting wrinkled (very painful and messy!) Not so hot landings that increase chances of eye getting bumped and wrinkling flap, even minor eye trauma early on causes problems. Chance of foreign body getting in eye.

Like I wrote above, chances are low, but is playing Russian roulette really worth it? I always let my patients know what can happen, in the end it is their eyes, they make the final decisions whether it be post-lasik care or any other treatment.

Jen

Do or do not, there is no try -Yoda

[kimgriffin 0]

Just my 2c...

I had LASIK by Dr Shugar a couple yrs ago. He had told me to wait 2 weeks before I jumped (coming from a top eye surgeon who's been skydiving for 20+ yrs). I waited a month just in case. All was perfect.

Here's the link to "contact us" on Dr. Shugar's website, in case you want to write him:

http://www.naturecoasteye.com/index.cfm/contactus/contactform

(Sorry if I'm a retard and didn't make it clicky.)

Yeah, it's amazing to see so clearly isn't it?? Congrats!!!

[MWGemini 0]

I can't speak with much experience on this one, as I had PRK and not LASIK, and I had it a few years ago, before I ever started jumping, but given the research I did at the time, PRK was a much safer (although more painful) option than LASIK. It's also the only one that the Army would perform (mainly because they were worried about the flap ripping during airborne operations if the LASIK procedure was used).

I've known people who have had LASIK, PRK, and LASEC, and the best results (especially for very active people) seem to be from PRK. Might be something worth looking into for you. At any rate, follow your doctor's orders to the letter. I know somebody who had a flap tear and it seriously affected their vision, even with corrective surgery.

Mike

[Speer 0]

I also had PRK. PRK is essentially the same procedure as LASIK for reshaping the eye, but there is no incision or flap. In PRK, the top layer of skin is ablated away by the laser, the the surface is reshaped. It then takes a couple days for the skin the regrow over the treated area. A major benefit to PRK is that the treated area of the eye is not nearly so deep, and there is no incision to heal. But as Mike said, there is a little more discomfort, but I will gladly have it done again without reservation.

The US Dept of Defense will not allow any procedure other than PRK for aircrew or jump qualified positions. The reason for that ruling is the extreme amount of time that the flap on LASIK sculpted eyes remains "unhealed". There are some surgeons who maintain that it will never really become completely secure. I was reading a statement from a LASIK surgeon a few days ago who had just performed a touch up procedure on one of his patients. At 29 months after the original procedure, he was still able to dislodge the original flap, allowing him to perform the touch up without having to make an incision for a new flap.

None of this apparently presents a grave threat to most people, but bear in mind that extreme conditions like we encounter in skydiving MAY dislodge the flap. Ensuring you have goggles or other dependable eye protection would seem to be imperative for skydivers who have had LASIK.

For those considering laser vision correction, I would strongly recommend that you get info on ALL the available procedures. LASIK is the "darling" procedure now, and everyone is being steered toward it, but there are alternatives that may be a much better choice for you. PRK is certainly available (even though many surgeons will say it is "Old Fashioned"), especially near military installations due to the DoD requirements.

Russ

Generally, it is your choice; will your life serve as an example... or a warning?

[peregrinerose 0]

Quote

For those considering laser vision correction, I would strongly recommend that you get info on ALL the available procedures. LASIK is the "darling" procedure now, and everyone is being steered toward it, but there are alternatives that may be a much better choice for you. PRK is certainly available (even though many surgeons will say it is "Old Fashioned"), especially near military installations due to the DoD requirements.

I agree. There is Orthokeratology which uses RGP contact lenses to mold the cornea. This is great for those with under -4.00 prescriptions and is non surgical, so less risk. There is now a new procedure called a phakic IOL. An artificial lens is slipped inside the eye which corrects for prescriptions higher than -6.00. This is far less invasive to the cornea and heals much quicker than lasik since the incision is made close to a blood supply. Drawback is that the lens is inside the eye, so can cause some initial inflammation. Side effects are basically the same as those who have had cataract surgery.

There is a new contact approved for sleeping in that I've had great luck with. Less risk than surgery there, a 2 week extended wear. Plus the night and day lenses which are 30 day extended wear. Parameters don't fit every patient. Those who smoke, have dry eye, sleep with eyes open, or are very allergy prone are not good candidates.

There are one day contacts, put the in every morning, throw them out every night, great for those who swim since they are the only lens I'll let you swim in (people pee in that water, you don't want it in your eye any longer than necessary!!). They are also good for us lazy people (it's what I wear most of the time)

Always discuss all the options with your eye doc, since refractive technology changes too quickly. By the time these procedures hit the news, they've been things we've known about for months.

Jen

Do or do not, there is no try -Yoda

[nate_1979 9]

Quote

I also had PRK. PRK is essentially the same procedure as LASIK for reshaping the eye, but there is no incision or flap. In PRK, the top layer of skin is ablated away by the laser, the the surface is reshaped. It then takes a couple days for the skin the regrow over the treated area. A major benefit to PRK is that the treated area of the eye is not nearly so deep, and there is no incision to heal. But as Mike said, there is a little more discomfort, but I will gladly have it done again without reservation.

The US Dept of Defense will not allow any procedure other than PRK for aircrew or jump qualified positions. The reason for that ruling is the extreme amount of time that the flap on LASIK sculpted eyes remains "unhealed". There are some surgeons who maintain that it will never really become completely secure. I was reading a statement from a LASIK surgeon a few days ago who had just performed a touch up procedure on one of his patients. At 29 months after the original procedure, he was still able to dislodge the original flap, allowing him to perform the touch up without having to make an incision for a new flap.

None of this apparently presents a grave threat to most people, but bear in mind that extreme conditions like we encounter in skydiving MAY dislodge the flap. Ensuring you have goggles or other dependable eye protection would seem to be imperative for skydivers who have had LASIK.

For those considering laser vision correction, I would strongly recommend that you get info on ALL the available procedures. LASIK is the "darling" procedure now, and everyone is being steered toward it, but there are alternatives that may be a much better choice for you. PRK is certainly available (even though many surgeons will say it is "Old Fashioned"), especially near military installations due to the DoD requirements.

Ya know, always wondered why the DoD used the old procedure, i had always just heard all the good about the new procedures, never the bad.. Thanks for this post, very informative, I think I will change my choice when i go to do it after reading this, or atleast look into it further...

FGF #???
I miss the sky...
There are 10 types of people in the world... those who understand binary and those who don't.

[Cayce 0]

I wasn’t going to reply to this originally but this kind of goes along the lines of what I was thinking just recently. I don’t know the first thing about PRK so I have no reference in that department. Yet I did have Lasik and about a year later I had a touch up. When I had the touch up the doctor actually was able to dislodge and pull up the cornea flap with a small plastic ‘spatula’. He didn’t make an additional cut, he just pulled up the original cut. Granted, he had to work at it and I doubt it would have come loose by it self. But it really un-nerved me that I had a physical defect that could be dislodged so easily.

So flash forward another year and I’m feeling fine in the eye department and not even thinking about it when I start skydiving. Somewhere around my 15th jump when I’m cleared for solo my goggles come loose and I have around 3000 feet of fall with full wind on my eyes as I’m trying to focus on the alti. Everything worked out fine, no problems with my eyes, and I figured out how to make sure my goggles don’t dislodge like that any more. But afterwards I was actually a bit unnerved in that I thought I still might have that ‘physical defect’ and maybe my cornea could have folded up with all of that pressure. Now maybe that’s unfounded and not even a concern but it did flash in to my mind for a while.

Having said that, I have never regretted the Lasik. I can serf, swim, work on computers, read, shoot, dive, skydive, and ski with much less concern than I ever did with contacts or blurry vision. It’s just that the slipped goggles reminded me of that plastic spatula…It was probably just psychosomatic, I could probably be fine if I did a dive without goggles, but I’m not going to try it.

[peregrinerose 0]

Quote

It’s just that the slipped goggles reminded me of that plastic spatula…It was probably just psychosomatic, I could probably be fine if I did a dive without goggles, but I’m not going to try it.

It absolutely should concern you! As I posted above, initial healing is a couple months, to tack the flap down reasonably well, but it takes years to regain the integrety of the inital pre surgery cornea. It takes a fair amount of trauma (slipped goggles catching your eye the wrong way, baseball to the eye, etc), but it can happen. That doesn't mean to not have surgery.

I consider it my job to essentially give worst case scenarios to my patients. They need to know every possible LASIK (or other procedure) outcome to make an educated decision. Sooner or later they will need glasses/contacts again (minimum reading glasses around 40ish). There is reduced contrast sensitivity, not a big deal at 30, but when combined with cataracts at 60 can decrease night vision even more. Permanently less tear film (not big deal at 30, but can cause more problems with age due to decreased tears with time), possible permanent starbursts at night or double vision. A successful lasik outcome is considered 20/40 vision, not 20/20, so not everyone achieves that. I refer them to the surgicaleyes web site so they can see exactly what can happen.

It is up to patients to weigh the risk/benefit ratio. Side effects are small, but they happen, even with very very good surgeons. I have seen it with the surgeon that I refer to on one patient out of many, but it happens.

I also make sure that people are perfect candidates... no pre-existing dry eye, rx within parameters, healthy cornea/retina, sufficient corneal thickness, pupils that are smaller than the surgical zone even in dark lighting conditions, no existing cataracts (cataract surgery does the same thing as refractive surgery, but insurance pays for it), realistic expectations (ie, the over 40 crowd probably will need readers), stable prescriptions over the past few years, no diabetes (slower healing/frequent prescription changes).

If a patient isn't a perfect candidate, I tell them exactly why and I won't refer them. I would rather lose the patient in my office and very high associated pre/post op fees than refer a less than ideal person for an optional surgical procedure. That is just how my medical ethics are, not saying it is right, it is just my way of doing things.

As patients, ask a million questions, be comfortable with your gut instincts and be 100% confident in your decision, your optometrist, and the surgeon doing the procedure. Refractive surgery is great, for the right people.

Us docs are on your payroll, if you aren't happy, fire us (even if it is me!!)

Jen

Do or do not, there is no try -Yoda

[GraficO 0]

thank you all for your input, educated guesses and professional optinions.

I got a green light from my doc that the flap has healed and in another 2 weeks the flap should be adhered back to they eye itself. As is well. As of now my vision is extrely improved and have 20/15 in the left and 20/25 in the right eye. So the average of 20/40 vision you mentioned I feel that i have done rather well.

Although I won't be doing any hardcore jumping or strapping the cameras down for another 2 weeks, I was able to make a balloon jump this morning. Very nice to get back in the air but not so hardcore that there was too much risk of a problem (fullface helmets)

Personally, I reccommend the proceedure to those who are thinking about it... again you need to feel comfortable with the docs and get a thorough exam to determine if you are a candidate or not. Words of wisdom are coming from Jen... I believe she really knows what she's talking about and has a good perspective on what to do and not to do. Biggest thing is to ask questions.

SEE you all at a DZ soon...

GraficO

GraficO

"A Mind is a terrible thing to taste."

[skysprite 0]

Quote

Although I won't be doing any hardcore jumping or strapping the cameras down for another 2 weeks, I was able to make a balloon jump this morning. Very nice to get back in the air but not so hardcore that there was too much risk of a problem (fullface helmets)

Glad to hear you got your balloon jump in.

~skysprite

[GraficO 0]

it was gorgeous Sunday morning... couldn't have asked for better balloon jump weather!

Yeah... you definately missed out ... Next time though

My only question to all of the balloon jumpers from that morning... I made it to tap the disk at the expert field... how come everybody else landing off in the desert?!?

Fly... be free! Keep jumping Powerpuff!

GraficO

GraficO

"A Mind is a terrible thing to taste."

[GentleTiger 0]

I've been thinking about having the LASIK done, but after reading these posts, there is no way I'm having anything done.

I don't like the eye doc to begin with...I know that as I'm getting older, my eyes are changing, I'll stick with my glasses and have THEM adjusted every couple of years.

I'm not afraid to be a coward!

BBS
Tiger

________________________________________
Look, up in the sky! It's a bird! It's a plane! It's a tiger in the sky!! Throw down some steaks and run for the hills!!!

[sky301 0]

I'm glad this thread appeared when it did, I have an appt. to see if I "qualify" for the procedure next week....and i'm planning on going to lake wales to check out the swooping comp in Feb.....doing some jumps as well of course. So if it all works out I'll definetly wait until I return for the procedure. I'll be sure to ask lots of questions at the exam.
So If i understand correctly following the procedure and the "inital healing period", wearing gatorz or similar type of shades in freefall wouldn't be recommended at all?....even after a few months? better to stick with goggles of some sort?

Mike C

Just Go with it

[flyangel2 2]

Quote

I made it to tap the disk at the expert field... how come everybody else landing off in the desert?!?

Cause you could see the landing area better

Adam, glad you got your jump in.

May your trails be crooked, winding, lonesome, dangerous, leading to the most amazing view. May your mountains rise into and above the clouds. - Edward Abbey

[skysprite 0]

How high were they able to take you for the jumps?

Quote

Fly... be free! Keep jumping Powerpuff!

Should be there this weekend!

Quote

Cause you could see the landing area better

~skysprite