Impact of Laser Vision Correction on Readiness and Operational Performance Among Active Duty Service Members.

Abstract

Introduction: Optimal visual performance is essential for modern military operations. Traditional forms of vision correction, including spectacles and contact lenses, may present operational limitations during deployment or field training. The Department of Defense established the Warfighter Refractive Eye Surgery Program (WRESP) to provide laser vision correction (LVC) to improve operational readiness by reducing reliance on corrective eyewear among active duty service members (ADSM). This study evaluated ADSMs' perceptions of overall satisfaction, visual outcomes, operational performance, and military readiness following LVC performed at the Joint Base San Antonio (JBSA)-Lackland, Joint Warfighter Refractive Surgery Center (JWRSC).

Materials and methods: A cross-sectional electronic survey was distributed to ADSM who underwent LVC at the JBSA-Lackland JWRSC between January 1, 2023, and December 31, 2025. The survey link remained active for 2 weeks. Survey domains included perceived visual outcomes, operational performance, confidence in military duties, nighttime operations, marksmanship, and overall satisfaction after laser vision correction. Inferential statistics, including Pearson's Chi-square tests and multivariable logistic regression, were utilized to compare perceived outcomes across surgical cohorts and identify potential predictors of reported performance declines.

Results: Of 1,971 successfully delivered survey invitations, 1,206 ADSM responded. Uncorrected distance vision improved in 99.00% of respondents, with no significant difference among procedures (P = .806). Overall satisfaction was also exceptionally high at 97.34%, which was statistically comparable across PRK (97.4%), LASIK (97.4%), and SMILE (97.2%) cohorts (P = .791). High rates of self-reported performance improvements were observed across key operational domains, including marksmanship (67.66%), physically demanding activities (78.36%), near-task performance (83.75%), deployment or field exercises performance (78.11%), tactical confidence (93.03%), and, with no significant differences by procedure type (all P > .05). A perceived decline in nighttime operations was reported by only 5.6% of respondents, occurring in 4.7% of PRK (95% CI: 3.6%-7.2%), 6.9% of LASIK (95% CI: 5.5%-11.8%), and 6.2% of SMILE (95% CI: 4.2%-12.7%) recipients (P = .184). In a multivariable logistic regression adjusting for age, sex, rank, and branch, procedure type was not significantly associated with nighttime decline (LASIK vs. PRK: P = .084; SMILE vs. PRK: P = .339). Additionally, 68.2% of respondents reported that LVC positively influenced their decision to remain in the military with no significant differences by procedure type (P = .661).

Conclusions: LVC is associated with substantial self-reported improvements in visual readiness and operational task performance, with exceptionally high, comparable satisfaction across PRK, LASIK, and SMILE cohorts. Reducing physical dependence on corrective eyewear is perceived to enhance readiness, justifying continued program investment and future objective longitudinal evaluations.