Fit to Fly of Commercial Pilot after Corneal Refractive Surgery

Corneal refractive surgery (CRS) is gaining recognition these days as a choice to correct refractive errors permanently, and the aviation community is no exception. Although studies have revealed that the number of pilots who have undergone CRS is relatively small, it is still deemed important to have knowledge about the intermediate and long-term visual outcomes after CRS, as vision is very important for pilots to ensure flight safety during their duty. This literature review elaborates the effect of CRS on contrast sensitivity, refractive regression, and dry eye, as these components are related to the quality of vision. We conducted a literature review by searching on Google Scholar, PubMed, and Science Direct with relevant keywords. We found that each variety of CRS has its own effects regarding contrast sensitivity, refractive regression, and dry eye, both for immediate and long-term effects following the surgery. Factors in the work environment of pilots, such as hypobaric hypoxia, low humidity, and ergonomic factors also have an influence on those visual outcomes. To conclude, we suggest several clinical practices for aviation medicine specialists for management of pilots with a history of CRS or a plan to have the surgery.