Aircrew fitness decisions and advances in refractive surgery techniques

Refractive surgery is a well mastered technique for the correction of ametropia. The results in terms of recovery of visual acuity are generally very satisfactory. However, when patients are applicants for pilot training it is necessary to consider the structural effects of the operation and its repercussions on the visual function. Since 1981, we have examined 273 eyes of subjects applying to flight crew. The alterations, in the corneal structure, in the sensitivity to contrasts, and in the resistance to glare have dampened the former enthusiasm of the operated. We have evaluated the functional and clinical consequences of each individual case as well as the administrative decisions made concerning these applicants. The outcome is that on average one of three applicants obtained a dispensation within a time limit ranging from 1 to 5 years after surgery, according to the field applied for.