Keeping an Eye on Laser Vision Surgery

October 28, 2013

If you are a pilot who needs vision correction to fly, consider yourself in the majority. More than half – 55 percent – of U.S. civilian pilots need some sort of correction to meet the FAA’s vision requirements.

For most pilots, that means bringing along an extra set of glasses on every flight. It means keeping track of those glasses, cleaning them and buying new ones whenever their vision changes and a new prescription is required.

That is why many pilots opt for corneal refractive surgery to correct their vision. But before making a decision on procedures like Lasik surgery, or one of its variants, there are a number of issues to consider. For instance, in terms of being qualified to fly after surgery, Lasik may not provide enough vision correction to make it possible to fly without corrective lenses.

“Flight crews still need to meet FAA standards,” said Dr. Quay Snyder, president and CEO of Aviation Medical Service. Those standards include 20/20 distance vision in each eye and 20/20 near- and mid-range vision (20/40 near- and mid-range vision for pilots over age 50).

“But success in procedures like Lasik is considered vision that’s 20/40 or better,” Snyder continued. “For pilots whose laser surgery provides less than 20/20 vision, that means they still have to wear corrective lenses in flight [and should carry an extra set of glasses as well].”

Dean Andrew Kantis is perhaps an extreme example of someone for whom laser eye surgery proved disastrous.

“My personal experience with Lasik had negative repercussions that resulted in ending my pilot career before it even began. Because of Lasik, which permanently ruined my vision, I will never be able to be a pilot,” Kantis wrote in a blog for Universal Weather and Aviation. As a result of laser eye surgery, some patients are unable to read the smallest letters on the vision chart, and that deficiency cannot be corrected with glasses, contact lenses or follow-up surgery, said Kantis, founder and owner of Mirco Jet Network, Inc.

Snyder points out that results from procedures like Lasik have improved dramatically in the past decade, and the procedure is considered both safe and economical. But he also points out the risks associated with laser eye surgery. They include:

• Dry eyes: The procedure often leaves patients with an inability to produce sufficient tears to see clearly, making them dependent on eye drops.
• Halos or starbursts: Predominantly suffered by those who have had recent Lasik surgery, these are problems that can have negative effects on flight vision – especially at night, according to Snyder.
• The need for reading glasses at a younger age. For those who are using Lasik to treat myopia or nearsightedness, there is a risk that they will require reading glasses years before they would have without undergoing laser eye surgery.

Still, Snyder said he is not an opponent of Lasik or its variants, but he does offer some suggestions for pilots seeking more information about the procedure.

“Use only a board-certified ophthalmologist with plenty of experience,” he suggested. As a rough minimum, Snyder suggested those who have conducted at least 5,000 procedures. “You don’t want to be a part of the ophthalmologist’s learning curve.”

He also strongly suggested following the doctor’s post-surgical advice to the letter.

“Your ophthalmologist will offer you several post-procedure eye exams,” Snyder said. “Pilots should ground themselves until they are able to see 20/20 with or without correction beyond surgery.”