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Night Carrier Operations

Spectacles ME5888

Soft Contact Lens ME5888

Contact Lenses

Is LASIK OK in the Aerospace Environment? ME5888

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

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

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

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 ME5888

These two studies profoundly changed DoD vision standards ME5888

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! ME5888

Is the Flap Stable Enough? ME5888

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

Is the Quality of Vision good enough? ME5888

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

Wavefront Guided LASIK ME5888

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

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 ME5888

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

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 ME5888

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

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

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 ME5888

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

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

First Naval Aviator to undergo LASIK ME5888

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 ME5888

We have entered a new era in laser vision correction ME5888