Refractive surgery in aircrew members who fly for scheduled and non-scheduled civilian airlines

Nakagawara, V.B., Wood, K.J., and Montgomery, R.W.

FAA Office of Aerospace Medicine - Civil Aerospace Medical Institute

关键词: Aviation;    Vision;    Refractive Surgery;    Aeromedical Certification;    Occupational Health;   

RP-ID  :  DOT/FAA/AM-00/19

美国|英语

来源: Federal Aviation Administration

【 摘 要 】

Introduction. Civil airmen with refractive surgery are present in all classes of aeromedical certificate holders. Refractive surgical procedures have been associated with numerous side effects, including glare, reduced contrast sensitivity, and fluctuating visual acuity. These side effects may render the quality of vision unacceptable in the cockpit environment. This study reviews the aeromedical certification experience with refractive surgery in aircrew members who fly for civilian airlines.Methods. Active airmen with FAA-specific pathology codes 130 (radial keratotomy) and 5179 (general eye pathology with surgical prefix) in the Consolidated Airman Information System medical database during the period 1 January 1994 through 31 December 1996 were identified. Airmen were stratified into those with a first-class medical certificate, an occupational code 1 (pilot, copilot, first, and second officer) or code 2 (flight engineer), and an employer code of a scheduled or nonscheduled airline. The medical records of these airmen were reviewed, and the clinical data were collated and analyzed.Results. A total of 133 flight crewmembers (125 pilots and 8 flight engineers) were identified as employees of airlines and having had refractive surgery. Seventeen airmen (12.8%) were miscoded and 2 airmen (1.5%) were lost to follow-up. Of the 114 pilots with refractive surgery, 97 (85.1%) were incisional procedures, 15 (13.2%) were laser procedures, and 2 (1.7%) were complex surgical procedures. Three airmen (2.6%) had serious complications resulting from the refractive procedure, including postoperative stromal haze, depth perception problems, and a perforated cornea and crystalline lens resulting in a cataract.Conclusions. The preponderance of aircrew members who have had refractive surgery and fly for scheduled or nonscheduled airlines have incisional refractive procedures, which reportedly have the most critical visual side effects. A considerable number of airmen have had laser procedures, of which the long-term effects are still unknown. Although some serious complications have resulted from refractive surgery, the study indicates these complications have not affected an applicant's ability to receive an airman medical certificate.