Abstract
BackgroundTo analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. A further aim was to analyze the percentages and visual symptoms associated with ADs and/or BDs in this population.MethodsOne hundred and eight civilian pilots who underwent CRS from January 2001 to July 2012 (age: 30.33 ± 4.60 years) were enrolled, the mean preoperative SE was − 1.51 ± 1.15 D (range: − 1.00- − 5.00 D). Ninety-nine emmetropic civilian pilots (age: 29.64 ± 3.77 years) who were age- and sex-matched to the CRS group were also enrolled. Refractive status, accommodative and binocular tests of each subject were performed. Visually related symptoms were quantified using the 19-item College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. The 19 items were summed to obtain visual symptom scores that might indicate visual dysfunctions. The chi-square test was used to analyze differences in percentages of ADs and/or BDs between the CRS and emmetropic groups. The Mann-Whitney U test was used to compare visual symptom scores between pilots with ADs and/or BDs and pilots with normal binocular vision.ResultsNo significant difference was observed between the CRS and emmetropic groups in the overall prevalence of ADs and BDs (15.7% and 15.2% in the CRS and emmetropic groups, respectively; P = 0.185). ADs were present in 4.63% and 3.03% of the CRS and emmetropic group, respectively. BDs were observed in 11.1% and 12.1% of the CRS and emmetropic group, respectively, yielding no significant differences between the groups in the prevalence of ADs or BDs (AD: P = 0.094; BD: P = 0.105). Pilots with ADs and/or BDs had significantly more visual symptoms than pilots with normal binocular vision (p < 0.001).ConclusionsCRS for civilian pilots with low-moderate myopia might not impact binocular functions. ADs and/or BDs commonly occur in both emmetropia pilots and pilots who undergo CRS, and pilots with ADs and/or BDs are associated with increased symptoms. This study confirms the importance of a full assessment of binocular visual functions in detecting and remedying these dysfunctions in this specific population.
Highlights
To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots
BDs (NSBVAs group) than pilots with normal binocular vision (NBV group), and the results revealed that the NSBVAs group had significant visual symptoms including losing attention (U = 41.50, p < 0.001), skips (U = 36.50, p < 0.001), holding reading close (U = 12.00, p < 0.001), Comprehension Down (U = 0.50, p < 0.001), omissions (U = 64.00, p < 0.001), words running together (U = 33.00, p < 0.001), up/ down (U = 68.00, p < 0.001), misaligns (U = 0.00, p < 0.01), and headaches (U = 15.50, p < 0.001) and a significant mean total College of Optometrists in Vision Development (COVD)-Quality of Life (QOL) score (U = 0.00, p < 0.001) (Fig. 1)
The present study demonstrated no significant differences in the prevalence of ADs and/or BDs between the CRS and emmetropic pilots, and binocular vision
Summary
To analyze whether corneal refractive surgery (CRS) is associated with the distribution of different accommodative dysfunctions (ADs) and binocular dysfunctions (BDs) in civilian pilots. Detection of clinically significant ADs and/or BDs is important, as some of these deviations may decompensate and become strabismic, resulting in the loss of stereopsis, suppression and a wide variety of associated visual and mental symptoms [6,7,8,9,10] Most of these studies are performed in pediatric populations [11,12,13,14], high school [15] and university students [16, 17]. Reports are lacking on the frequency of ADs and/or BDs among pilots This population is of great interest because their workforce has perhaps the greatest amount of near work of any population [18], and the presence of ADs and/or BDs may result in visual symptoms that affect flight performance and leisure activities. This matter should be investigated, as flying is widely viewed as a mentally and visually demanding task within a degraded visual environment
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