United States Department of Transportation
i
Refractive Surgery in the Civil Airman Population by Class of Medical Certificate and by Aviation Occupation
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1999-02-01
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Edition:Final Report
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Abstract:Refractive surgical procedures performed in the United States have increased in recent years and continued growth is projected in the near future. These procedures have been associated with numerous side-effects, including glare, reduced contrast sensitivity, and fluctuating visual acuity. The quality of vision after refractive surgery may be unacceptable in a cockpit environment. This report reviews the aeromedical certification experience with the refractive surgery population. Methods. Active airmen with FAA-specific pathology codes 130 (radial keratotomy) and 5179 (general eye pathology with surgical prefix), during the period 1 January 1994 through 31 December 1996, were identified in the Consolidated Airman Information System medical database. The medical records of airmen with pathology code 5179 were reviewed. Airmen identified by records review as having had refractive surgery, and those with pathology code 130 were collated into a database and analyzed against demographic data extracted from Federal Aviation Administration (FAA) publications. Airmen with refractive surgery were further stratified by aviation occupation (pilot, copilot, first and second officer, and flight engineer). Results. There were 3,761 airmen identified as having had some type of refractive surgical procedure during the study period. The prevalence rate of refractive surgery in the total civil airman population was 6.21/1,000 airmen. By class of airman medical certificate, the prevalence rate was 3.60/1,000 for first-class, 6.26/1,000 for second-class, and 7.43/1,000 for third-class holders. A total of 133 airmen (125 pilots and 8 flight engineers) with refractive surgery was identified as employees of scheduled and nonscheduled airlines. Conclusions. Airmen who have had refractive surgery are present in all classes of civil aeromedical certificate holders, including a substantial number of crewmembers who fly for commercial airlines. The substantial presence and the anticipated increased incidence of such procedures in the airman population warrant special monitoring and evaluation of operational problems involving these pilots.
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