PRESBYOND Laser Blended Vision LASIK in Commercial and Military Pilots Requiring Class 1 Medical Certification

Abstract

Purpose: To report the outcomes of PRESBYOND Laser Blended Vision LASIK (Carl Zeiss Meditec AG) in presbyopic commercial and military pilots requiring Class 1 aeromedical certification. Methods: This was a retrospective study of 23 consecutive pilots who underwent PRESBYOND Laser Blended Vision LASIK. Postoperative visits were conducted at 1 day and 1, 3, and 12 months. Standard outcomes analysis was performed using the data at 12 months. Objective quality of vision measures including mesopic contrast sensitivity (CSV-1000; VectorVision), Ocular Scatter Index (HD Analyzer; Keeler), and straylight (C-Quant; Oculus Optikgeräte GmbH) were determined before and 3 months after surgery. A questionnaire to assess the functional vision of pilots before and after surgery was derived to record subjective outcomes. Results: Of the 23 pilots treated, data were available at 12 months for 22 pilots (95.7%) and at 3 months for 1 pilot (4.3%). Median age was 55 years (range: 42 to 65 years). At 12 months, binocular uncorrected distance visual acuity was 20/20 or better in 100% and 20/16 or better in 52% of pilots. Binocular uncorrected intermediate visual acuity was J3 in 73%, J5 in 95%, and J10 in 100% of pilots. Binocular uncorrected near visual acuity was J1 or better in 78% and J2 or better in 100% of pilots. Mean postoperative spherical equivalent refraction relative to the target was −0.04 ± 0.34 diopters (D) (range: −0.63 to +0.63 D), with 93% within ±0.50 D. There was a statistically significant increase in contrast sensitivity at 3, 6, 12, and 18 cpd. C-Quant straylight was 1.07 ± 0.16 before surgery and 1.06 ± 0.16 at 1 to 3 months after surgery ( P = .705). All pilots achieved Class 1 medical certification from the United Kingdom Civil Aviation Authority and resumed flying. All pilots reported improved functionality compared to the previous vision correction method. Conclusions: PRESBYOND Laser Blended Vision LASIK enabled presbyopic commercial pilots to continue to fly without the need for glasses. With consideration of the visually challenging cockpit environment, PRESBYOND Laser Blended Vision LASIK provides clear continuous vision for tasks at near, intermediate, and far distance. Class 1 pilots reported a subjective improvement in visual tasks and comfort following surgery. [ J Refract Surg . 2023;39(1):6–14.]