Occupational Outcomes of Photorefractive Keratectomy in Young Asian Military Aviators

The Republic of Singapore Air Force started its corneal refractive surgery (CRS) Program in 2005 through the introduction of photorefractive keratectomy (PRK) to expand its recruitment pool of aviators. This study evaluates short- and long-term occupational outcomes of PRK on young Asian eyes with low-moderate myopia.

This is a retrospective cohort study of aircrew who underwent PRK under the CRS program over 12 yr. Data collected included demographic characteristics, preoperative spherical equivalent (SE) refraction, pachymetry, keratometry, pre- and postoperative uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity, and SE refraction. Outcome measures included long-term survival rates (i.e., achieving UDVA of 20/20 and flying without optical aids), short-term SE refractive accuracy/UDVA, and postoperative complications.

Included for analysis were 274 eyes of 141 patients. Of these, 82.1% of eyes had UDVA of 20/20 at last follow-up. Cumulative survival rates were 99.8%, 96.5%, 92.9%, 84.7%, and 62.2% at 1, 2, 3, 5, and 10 yr of follow-up, respectively. At the 3-mo mark, 98.2% and 70.4% of eyes had SE refraction within ±0.50 D and ±0.13 D of intended correction, respectively, and 95.2% of eyes met standards for returning to flying duties. Postoperative complications included corneal haze (1.5%), steroid-induced intraocular pressure elevation (0.7%), and PRK-enhancement (0.7%). Higher preoperative myopia was the only risk factor for failure from multivariate analysis.

PRK as a structured CRS program is effective both short- and long-term to enable flying without optical aids among young Asian aviators with low-moderate myopia. Ong SC, Chay I, Low J, Tan D, See B. Occupational outcomes of photorefractive keratectomy in young Asian military aviators. Aerosp Med Hum Perform. 2025; 96(2):121-127.