PMID- 21043303
OWN - NLM
STAT- MEDLINE
DCOM- 20101130
LR  - 20191027
IS  - 0095-6562 (Print)
IS  - 0095-6562 (Linking)
VI  - 81
IP  - 11
DP  - 2010 Nov
TI  - Permanent grounding of a USAF pilot following photorefractive keratectomy.
PG  - 1041-4
AB  - INTRODUCTION: Photorefractive keratectomy (PRK) has been extensively studied in 
      the literature and its potential application in aircrew has not gone unnoticed. 
      Complication rates following corneal refractive surgery (CRS), including PRK and 
      laser in-situ keratomileusis (LASIK), remain low, with most patients achieving 
      improved uncorrected visual acuity and reduced spectacle dependence. Overall, 
      predictability, low complication rates, high rate of success, stability, and 
      safety have all been cited as instrumental in the adoption of PRK in aviators. 
      Consequently, the U.S. Air Force (USAF) approved PRK for aviators in August 2000. 
      However, quality of vision outcomes following CRS remain a concern given the 
      unique visual performance requirements in military aircrew, especially in austere 
      operational environments. CASE REPORT: This paper will present a recent case of 
      steroid-induced ocular hypertension that is believed to have precipitated 
      non-arteritic anterior ischemic optic neuropathy (NA-AION) associated with 
      reduced visual performance following PRK that resulted in the first permanent 
      grounding of a USAF pilot following CRS. DISCUSSION: CRS has radically widened 
      the aircrew applicant pool and has decreased spectacle dependence in 
      war-fighters. Despite the low-risk profile of modern CRS, this case demonstrates 
      the potential for poor outcomes from such elective surgery. Understanding these 
      rare, but potentially devastating complications and the unique aeromedical risk 
      factors in aircrew is paramount when considering elective vision-enhancing 
      surgery.
FAU - Davis, Ryan E
AU  - Davis RE
AD  - Aeromedical Consultation Service, USAF School of Aerospace Medicine, 2507 Kennedy 
      Circle, Brooks City-Base, TX 78235, USA.
FAU - Ivan, Douglas J
AU  - Ivan DJ
FAU - Rubin, Richard M
AU  - Rubin RM
FAU - Gooch, John M
AU  - Gooch JM
FAU - Tredici, Thomas J
AU  - Tredici TJ
FAU - Reilly, Charles D
AU  - Reilly CD
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Aviat Space Environ Med
JT  - Aviation, space, and environmental medicine
JID - 7501714
RN  - 0 (Glucocorticoids)
RN  - SV0CSG527L (Fluorometholone)
SB  - IM
MH  - *Aerospace Medicine
MH  - Color Vision Defects/chemically induced
MH  - Elective Surgical Procedures/adverse effects
MH  - Fluorometholone/*adverse effects
MH  - Glucocorticoids/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Military Personnel
MH  - Occupational Health
MH  - Optic Neuropathy, Ischemic/*chemically induced
MH  - Photorefractive Keratectomy/*adverse effects
EDAT- 2010/11/04 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/11/04 06:00
PHST- 2010/11/04 06:00 [entrez]
PHST- 2010/11/04 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - 10.3357/asem.2857.2010 [doi]
PST - ppublish
SO  - Aviat Space Environ Med. 2010 Nov;81(11):1041-4. doi: 10.3357/asem.2857.2010.