THE AEROMEDICAL CERTIFICATION OF PHOTOREFRACTIVE KERATECTOMY IN CIVIL AVIATION: A REFERENCE GUIDE

Radial keratotomy (RK), the first widely accepted surgical procedure to correct refractive errors, involves making radial incisions on the peripheral cornea. These incisions weaken the cornea and allow intraocular pressure to push the peripheral cornea out, flattening the apex and reducing refractive power. There are many disadvantages with RK, including reduced corneal strength, fluctuation of vision, glare, poor refractive predictability and altitude-induced corneal changes, that raise concerns regarding its use in the aviation environment. In 1995, the use of the excimer laser to perform photorefractive keratectomy (PRK) to reshape the anterior curvature of the cornea was approved. Since that time, PRK has become the refractive surgical procedure of choice. It has been reported that for low to moderate levels of myopia there is greater predictability, no fluctuation of vision or reduction in corneal strength, and about 85% of patients have uncorrected visual acuity of 20/40 or better. As with RK, there are aspects of PRK that raise concerns about its use in the aviation environment. Some of these include: night vision problems, reduced contrast sensitivity, stability of refraction, reduced best-corrected visual acuity, and induced anisometropia. Using a mathematical model, it was estimated that by the year 2000 there may be over 1,200 civil airmen who elect to have PRK performed. To provide the aeromedical community with information to formulate administrative decisions and policies associated with this new refractive surgical procedure, this paper reviews the results of clinical trials on PRK and discusses its applicability in aviation.

• Record URL:
  http://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/1990s/media/AM98-25.pdf
• 
• Record URL:
  https://rosap.ntl.bts.gov/view/dot/57909
• Corporate Authors:

  Federal Aviation Administration

  Office of Aerospace Medicine, 800 Independence Avenue, SW
  Washington, DC  United States  20591
• Authors:
  • Nakagawara, V B
  • Wood, K J
• Publication Date: 1998-9

Language

• English

Media Info

• Features: Appendices; Figures; References; Tables;
• Pagination: 49 p.

Subject/Index Terms

• TRT Terms: Air pilots; Aviation medicine; Certification; Civil aviation; Controlled trials; Eye; Glare; Lasers; Mathematical models; Night vision; Surgery; Vision; Vision disorders
• Uncontrolled Terms: Photorefractive keratectomy; Radial keratotomy
• Subject Areas: Aviation; Education and Training; Safety and Human Factors;

Filing Info

• Accession Number: 00931289
• Record Type: Publication
• Report/Paper Numbers: DOT/FAA/AM-98/25
• Files: NTL, TRIS, USDOT
• Created Date: Sep 27 2002 12:00AM