In December 2004, then-Secretary of Defense Donald Rumsfeld told an Iraq-bound group of soldiers who had criticized the quality of their equipment that “you go to war with the army you have, not the one you might want or wish to have at a later time.”
But today, thousands of soldiers are going to war armed with the eyes they always wanted.
Legions of servicemen in Iraq have undergone a medical procedure whereby their near-sighted corneas are shaped to perfection. This experiment is believed to be the first by any army anywhere to use irreversible surgery to enhance combat power. “This is the single most important thing, second to maybe warfare training, that we need to do for our soldiers who are on the front lines,” said Maj. Nick Pefkaros, an Army ophthalmologist at Ft. Riley, Kan.
“If they lose their contacts or they lose their glasses in the middle of a fight,” said Pefkaros, “all of their training is equal to a 4-year-old with an AK-47.”
Since just before the start of the war in Iraq, Army eye surgeons have corrected the vision of nearly 55,000 soldiers for free in a campaign to increase their battlefield ability. The cost to the Army is $300 to $500 a head — far below what a civilian would pay.
“This is the first time that a medical procedure has improved the combat power of a military,” said Dr. Steven Schallhorn, a retired Navy captain who pioneered the research, development and propagation of the procedure for U.S. forces and is renowned in the field.
The Army began offering the surgery to Green Berets at Ft. Bragg in June 2000, and since May 2002 the Warfighter Refractive Eye Surgery Program, as it came to be called, has sharpened the vision of soldiers using a technique called photorefractive keratectomy, or PRK. Microscopic lasers bombard the patient’s corneas in a reshaping process that normally takes less than two minutes per eye and makes them as good as new within months.
Unlike unpopular and compulsory medical rituals of the past, such as anthrax shots and malaria pills, PRK is voluntary.
“I had 20/50 vision before, but having 20/20 is amazing,” said Gary Graig, 28, who received the surgery in Landstuhl, Germany, in order to improve his marksmanship before his second Iraq deployment.
For some soldiers, looking good can be just as important as seeing well. Visually impaired recruits suffer the indignity of wearing bug-eyed Army-issue glasses dubbed BCGs, or “birth-control goggles,” due to their unflattering appearance.
But with the Army’s offer of free PRK, soldiers can improve their image without paying the thousands of dollars that cosmetic-conscious civilians shell out for the surgery.
“It gave me tremendous confidence,” said Brian Pugh, 29, a Shell Corp. project engineer in Houston who underwent the operation after returning from a tour in Iraq. “I feel better as well as see better.”
Although two-thirds of civilian patients choose Lasik, a more complicated procedure that carries greater risk but involves a shorter healing time, the Army almost exclusively uses the more predictable PRK.
Lasik patients leave the operating table with immediate 20/20 vision, the laser doing its work only after a “hinged flap” has been sliced off the cornea and opened like a front-loading washing machine. That delicate flap never completely heals, making some soldiers — whose jobs include parachuting out of airplanes or enduring blasts in sandy areas — particularly ill-suited for the procedure.
But that could soon change too, according to Schallhorn. A new procedure called femtosecond surgery, the Navy’s technique of choice, cuts a flap that withstands the kinds of rigorous conditions that soldiers regularly endure.
