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2012.10.01-ME5888. Night Carrier Operations Spectacles 2012.10.01-ME5888.

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Presentation on theme: "2012.10.01-ME5888. Night Carrier Operations Spectacles 2012.10.01-ME5888."— Presentation transcript:

1 2012.10.01-ME5888

2 Night Carrier Operations

3 Spectacles 2012.10.01-ME5888

4 Soft Contact Lens 2012.10.01-ME5888

5 Contact Lenses

6 Is LASIK OK in the Aerospace Environment? 2012.10.01-ME5888

7 “Retention” Study 785 aviators treated with PRK >45,000 flight hours >12,000 landings Refractive Surgery in Naval Aviators 2012.10.01-ME5888

8 Complications Corneal haze (9 aviators) –Late haze with loss of best vision –Treated with steroids –Grounded but all eventually resumed flying 2012.10.01-ME5888

9 Students allowed into flight training that previously underwent PRK “Accessioning” Study 2012.10.01-ME5888

10 PhasePrimary Intermediate + Advanced PRKControlPRKControl Attrition (160 th -195 th weeks) 6.9%*10.7%1.4%*5.1% * Significantly lower Student Naval Aviator Accessioning Study: Cumulative Attrition Rate 2012.10.01-ME5888

11 These two studies profoundly changed DoD vision standards 2012.10.01-ME5888

12 The “Achilles' Heel” of PRK Prolonged visual recovery –Minimum aviator ‘down’ time is 3 months LASIK offers faster recovery –Faster return to cockpit Qualification to land on an aircraft carrier is ONE week! 2012.10.01-ME5888

13 Is the Flap Stable Enough? 2012.10.01-ME5888

14 Gun Chamber Pressure (lbs/in 2 ) Halo 400 knot ejection Flap Displacement Force Gauge (lbs) 2012.10.01-ME5888

15 Is the Quality of Vision good enough? 2012.10.01-ME5888

16 Change in 5% Contrast Acuity LogMAR Acuity 20/32 20/40 20/32 20/40 PRK LASIK High myopia Moderate Low 2012.10.01-ME5888

17 Wavefront Guided LASIK 2012.10.01-ME5888

18 Loss of ≥ 2 Lines: Conv13% WFG1.1% p=0.00 Conventional vs WFG LASIK WFG provides better Contrast Acuity 2012.10.01-ME5888

19 What is the Best Microkeratome to perform LASIK in Aviators? 1 Excimer –VISX Star S4 CustomVue 2 Surgeons 3 Keratomes –Mechanical: Amadeus & Hansatome –Femtosecond: Intralase 2012.10.01-ME5888

20 Loss of ≥ 2 Lines: Mech3.1% Femto1.1% p=0.00 Mech Keratome vs Femtosecond Femto provides better Contrast Acuity 2012.10.01-ME5888

21 Matched retrospective analysis 1,000 eyes IL 1,000 eyes MK Myopia < 3.0D Cyl <= 0.75D Femtosecond-Mechanical Comparison: % of eyes achieving 20/20 UCVA 2012.10.01-ME5888

22 Improving Outcomes WFG WFGFourier MSE Standard Deviation Year 50% 100% 75% % 20/16 UCVA Star S3 Star S2 n = 1168 3 mo postop 2012.10.01-ME5888

23 Comparison of Night Driving Performance After Wavefront- Guided and Conventional LASIK 2012.10.01-ME5888

24 Preop to Postop Difference in NDS Performance with Glare Conventional WFG with femto flap Preop to postop change in feet Worse after surgery Improved after surgery 2012.10.01-ME5888

25 LASIK “Best of the Best” Create the LASIK flap with a femtosecond laser Correct refractive error with WFG ablation 2012.10.01-ME5888

26 Optical Express 1 mo. UCVA after iLASIK (24,928 eyes of 13,283 consecutive pts) Age: 18 to 69 yrs Sph: -0.25 to -6.0D Cyl: 0.0 to -6.0D 2012.10.01-ME5888

27 First Naval Aviator to undergo LASIK 2012.10.01-ME5888

28 What Happened Next… April 07: NASA MAB meetingApril 07: NASA MAB meeting –Recommends approval of LVC based on improved results of WFG and femtosecond LASIK May 07: USAF approves LASIKMay 07: USAF approves LASIK –All aviation categories (tx in AF centers) –Recommends WFG and femtosecond laser Sept 07: NASA approves LASIK for astronaut applicantsSept 07: NASA approves LASIK for astronaut applicants –Preop +4 to -8D MSE, up to 3D cyl 2012.10.01-ME5888

29 We have entered a new era in laser vision correction 2012.10.01-ME5888

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