New research published in the Journal of Refractive Surgery has found promising outcomes for the use of Presbyond laser-blended vision LASIK (Carl Zeiss Meditec AG) in presbyopic aviation pilots with a Class 1 certification.
Tell me about this laser correction first.
Zeiss’s Presbyond laser-blended vision is used during LASIK surgery in tandem with the company’s CRS-Master (250 Hz) or Refractive Workplace (250 to 500 Hz) technology combined with its MEL 90 excimer laser.
The software creates a binocular laser vision correction approach for patients, along with customized treatments for ablation profiles, preoperative spherical aberrations, micro-anisometropia, and functional age of the eye.
How about this Class 1 certification?
A Class 1 medical certificate is a mandatory prerequisite for pilots obtaining a flight license and intending to fly airline transport planes (i.e. commercial airline pilot or charter captain). Testing is conducted in a number of categories, including general health, hearing, neurological, and ocular. See here for the complete list.
Once issued, the certificate is valid for 12 months, unless a pilot is 40+ and flies as a single pilot for commercial flights or is over the age of 60. In these cases, the certificate is valid for 6 months.
Now talk about the study.
The retrospective, non-comparative case series enrolled 23 commercial and military presbyopic pilots in the United Kingdom between the ages of 42 and 65 (median age = 55). All participants received Presbyond laser-blended vision LASIK using either the MEL 80 or MEL 90 lasers and VisuMax femtosecond laser (Zeiss).
Postoperative visits took place on Day 1 (including a spherical refraction) and Months 1, 3, and 12—all of which included routine measurements of monocular and binocular uncorrected distance visual acuity (BUDVA)—with standard outcome analysis performed based on Month 12 data.
Did the pilots have any post-op treatments?
The pilots wore plastic shields while sleeping for seven nights. They also applied tobramycin and dexamethasone (Tobradex; Alcon) and moxifloxacin (Moxivig: Novartis Pharmaceuticals UK Ltd) four times a day for the first seven days.
Data from all but one participant (95.7%) was available at Month 12 and at Month 3 for one participant (4.3%).
- BUDVA at 12 months was 20/20 or better in 100% of participants and 20/16 or better for 52% of participants.
- Binocular uncorrected intermediate VA was reported as J3 in 73%, J5 in 95%, and J10 in 100% of participants.
- Binocular uncorrected near VA was J1 or better in 78% and J2 or better in 100% of participants
A statistically significant increase was observed in contrast sensitivity at 3, 6, 12, and 18 cycles per degree (cpd) for all participants.
A questionnaire distributed to participants before and after the study to gauge the pilots’ functional vision showed that 83.3% of pilots reported achieving full independence from glasses, 88% reporting improved comfort, and 12% no change. All pilots achieved recertification within 8 weeks post-op.
According to study authors, this is the first report on the efficacy of refractive surgery for presbyopic commercial and military pilots.
They also concluded the data demonstrates that the use of Presbyond laser-blended vision LASIK enabled the presbyopic commercial pilots to continue flying without a need for glasses, providing clear and continuous vision for near, intermediate, and far-distanced tasks.