LASIK and the Possible Repercussions for Flight Crew – Understanding Your Options
This is a post by guest author Dean Andrew Kantis, founder and owner of Micro Jet Network, Inc. Dean was asked to contribute to this blog because of his personal experiences in dealing with the repercussions of LASIK. Any thoughts expressed below are entirely Dean’s and do not necessarily reflect the views of Universal Weather and Aviation, Inc.
This article is part 1 in a 2-part series covering the known risks LASIK surgery can have on flight crew members.
LASIK (or Laser-Assisted In Situ Keratomileusis) is a relatively new laser eye surgery technology. The first laser was approved for LASIK in 1996; however, the long-term safety and effectiveness of the surgery are still not clearly understood. Before pilots or crew members commit to eye surgery, it’s important that they assess the risks and alternatives.
My personal experience with LASIK had negative repercussions that resulted in ending my pilot career before it even began. Because of LASIK, which permanently ruined my vision, I will never be able to be a pilot.
My goal is to elevate awareness of the risks associated with LASIK. My intention is not to create fear, but rather an understanding of the known potential long-term injuries that are associated with this elective procedure so that you and others can make the most informed choice in regard to eye surgery. There are potential complications to be mindful of, and safer options may be available, depending on your individual situation.
Here’s an overview of what pilots and crew members should be aware of before electing for LASIK:
1. What is LASIK laser eye surgery?
LASIK surgery is performed by an ophthalmologist using a laser or microkeratome to reshape the eye’s cornea in order to improve clarity of vision. For most patients, LASIK can provide a temporary alternative to eyeglasses or contact lenses. However, the potential side effects from this surgery can include halos, starbursts, night-driving problems, keratoconus (corneal ectasia) and ongoing eye dryness – all of which are adverse and permanent consequences of this procedure.
2. What happens during laser eye surgery and what are the risks?
LASIK uses a laser beam to thin out the eye’s cornea to try to achieve vision as close to 20/20 as possible. The risk is that you’re permanently altering the natural curvature of both eyes in irreversible/irreparable ways that no longer allow the eye’s natural tear film to spread out evenly over the eye as it was designed to do. Corneal nerves that are severed and then ablated may no longer produce sufficient tear film to keep the eyes hydrated as they were intended to be. Thus, the number one complaint with the surgery is "LASIK dryness" that may never go away.
As with any surgery, things may go wrong, or become undone later, that may not be possible to correct down the road. LASIK, and other forms of irreversible vision corrective surgery, have potential adverse effects that can be incompatible with flying duties. These include corneal scarring or opacities, worsening or variability of vision, night glare, double vision, loss of detail and contrast, loss of three-dimensional vision and haziness of vision. There are cases of pilots who’ve spent tens of thousands of dollars trying to cure/fix post-LASIK cornea problems and had to retire prematurely due to seeing "two runways" instead of one, while others report seeing double vision of cockpit instruments and halos instead of clarity of instruments. Obviously, such problems create risks for the pilots, the crew members and, of course, the passengers.
3. Should flight crew members consider this type of surgery?
Many pilots may feel that their contacts or glasses bother them. What many pilots may fail to recognize is that elective LASIK is irreversible and, essentially, a temporary fix. The eyes will continue to change as we age, and challenges for those who’ve had LASIK surgery include daily dry eye syndrome – caused by cutting the corneal nerves. The eyes no longer produce sufficient tears/hydration to see clearly, and pilots may end up becoming dependent on an array of daily dry eye drops to find some type of "normalcy." Also, at higher altitudes and varying cabin pressures, eye pressure and intraocular pressures can change due to LASIK procedures. It is a fact that LASIK reduces by 98% the tensile strength that keeps the eye’s shape "regular" or "normal."
4. What options do flight crew members have when it pertains to laser eye surgery?
There’s been much advancement in variety, material, shape and sizes of contact lenses over recent years, and these options should be carefully considered as alternatives to LASIK. New Rigid Gas Perm lenses, for example, provide the greatest enhanced clarity of vision available due to the superior quality of the lens materials creating the ultimate optics. There are also daily disposable soft lenses available for astigmatics, as well as shaded/colored soft and hard lenses to help with glare issues. The advantage with non-surgical options is that you may achieve clarity of vision without altering the shape of your eyes and risking associated complications.
5. What are FAA regulations pertaining to LASIK or laser eye surgery?
The following information is from the "Information for Pilots Considering Laser Eye Surgery" published by the FAA:
- Age 18 years or older
- Stable refractive error (less than .50 diopters [D] change within the last year) correctable to 20/40 or better
- Less than -15.00 D of myopia and up to 6 to 7 D of astigmatism
- Less than +6.00 D of hyperopia and less than 6 D ofastigmatism
- No gender restriction, with the exception of pregnancy
- Pupil size less than or equal to 6 mm (in normal room lighting)
- Realistic expectations of final results (with a complete understanding of the benefits , as well as the possible risks)
In addition to conforming to the above criteria, it is important that you possess normal ocular health and be free of pre-existing conditions that may contraindicate LASIK.
Relative Risk of Post-Surgical Complications:
- Prolonged healing periods: 3 months or more
- Night glare (halos, starbursts): 1 in 50
- Under/over-correction: less than 1 in 100
- Increased intraocular pressure: non-significant
- Corneal haze: 1 in 1,000
- Corneal scarring: non-significant
- Loss of BCVA: 1 in 100
- Infection: 1 in 5,000
- Corneal flap complications (dislocated flap, epithelial ingrowth): less than 1 in 100
Information on pilot vision has been published by the FAA and can be found on the FAA’s website.
Due to the risks associated with laser eye surgery – and the fact that changes to eye structure are permanent, meaning essentially irreversible, it’s important that pilots and crew members take the time to make an informed decision based on risks versus benefits. Before committing to LASIK, you may want to consider other vision enhancement options. They are easier to adjust than the after-effects of a LASIK operation.
If you have any questions about this article, contact me at email@example.com.
In part 2 of this article, we’ll delve deeper into the risks of LASIK procedures and repercussions.