Presbyond laser blended vision LASIK may be good choice for presbyopic pilots
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A study conducted in the United Kingdom found “excellent” outcomes for Presbyond laser blended vision LASIK in pilots requiring Class 1 certification.
All pilots achieved the vision criteria for aeromedical recertification by 8 weeks after treatment.
Presbyond laser blended vision LASIK (Carl Zeiss Meditec) increases the depth of field and corrects presbyopia by inducing micro-anisometropia and a controlled amount of spherical aberration. The low level of induced anisometropia is well tolerated, and stereoacuity is maintained.
“Presbyopia is increasingly becoming a prominent safety concern for the aging population of pilots. Presbyopic pilots are often faced with the unique challenge of operating in visually demanding conditions, requiring clear, continuous vision at a range of distances and viewing positions often limited by spectacles or contact lenses,” Dan Z. Reinstein, MD, MA, lead study author, told Healio/OSN.
The study included 23 consecutive presbyopic pilots requiring Class 1 certification who underwent Presbyond laser blended vision LASIK using the MEL 80 or MEL 90 excimer laser and Visumax femtosecond laser (Carl Zeiss Meditec) between 2012 and 2019 at London Vision Clinic.
All patients achieved 20/20 uncorrected binocular visual acuity at distance and J2 at near. Intermediate vision was J3 or better in 73% of the patients, J5 in 95% of the patients and J10 in 100% of the patients. These results met the requirements for Class 1 medical certification from the U.K. Civil Aviation Authority. In addition, all patients achieved a statistically significant increase in contrast sensitivity. The results of a questionnaire showed a broad-ranging improvement in cockpit functionality, with 83.3% of Class 1 pilots reporting that they achieved full spectacle independence and 88% reporting improved comfort.
Other methods of correcting presbyopia in pilots have drawbacks, the authors said. Spectacles with progressive, bifocal or trifocal lenses have the problem of frames, which restrict the field of view. Contact lenses worn in the cockpit environment are easily dehydrated or displaced due to g-force, and multifocal lenses are associated with visual phenomena and loss of contrast sensitivity.
“This study has demonstrated the full range of visual requirements of presbyopic pilots can be met by Presbyond laser blended vision LASIK, achieving excellent visual, safety and functional outcomes at all distances,” Reinstein said. “In addition, all pilots reported that their newly gained spectacle independence improved cockpit functionality and, they felt, safety when compared with their previous refractive correction method of glasses or contact lenses. Most importantly, these results were achieved without the potential visual compromises that are inherent to diffractive or refractive segmental extended depth of focus intraocular lenses often used in the context of clear lens exchange for presbyopia.”
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