Aphakia and artificial lens implants in the civil airman population

The Federal Aviation Administration allows civilian airmen with aphakia to fly with waivered certificates. This study analyzes, in the civil airman population, the distribution of aphakia and intraocular lens (I.O.L.) implant by type (unilateral, bilateral), class of airman medical certificate, and gender, for a 4-year period (1982-85). Medical records were individually evaluated for all certified airmen who were carrying FAA-specific codes for the pathology categories during the study period. The prevalence of both aphakia and I.O.L. increased most for bilateral type and second-class certificate holders. During the study period, the prevalence of aphakia increased most for males and I.O.L. increased most for females. The incidence declined in both pathology categories during the later years of the study period. Implications for aeromedical certification of the increasing prevalence of aphakia and I.O.L. in the civil airman population are discussed. The modification of surgical procedures for cataract extraction and evolution of I.O.L. devices strongly suggests continued specialized aeromedical certification and clinical research review.