Laser and refractive eye surgery

Developed in collaboration with CASA Medical.

Refractive eye surgery is used to correct refractive errors such as near and far sightedness, astigmatism or presbyopia. Some procedures reshape the cornea, also known as keratorefractive surgery (LASIK, LASEK, conductive keratoplasty). While others implant a lens in the eye (phakic intraocular lenses and refractive lens exchange). The type of surgery is often dependent on type and degree of refractive error, certain patient factors and patient preference. 

Each procedure carries risks and complications that may have important aeromedical implications. These include temporary or permanent eye pain, blurry vision, dry eyes, halos, double vision, decreased visual acuity in low light, light sensitivity, and rarely eye infections, worsening vision and blindness. 

Pilots and controllers should consider carefully the pros and cons of refractive surgery, weighing the risks versus the benefits, and should not undergo a procedure just to meet the requirements of a medical certificate.

This is an area of rapid technological innovation, and not all procedures may be acceptable for certification. Pilots and controllers should consult with their treating specialists and review CASA or CAA NZ guidelines before undergoing procedures. There is a small risk of complications that may result in loss of certification. Pilots and controllers with mono-vision correction need to meet the CASA or CAA NZ standards and therefore may require prescription lenses. Pilots and controllers should be aware that near refraction can change with aging and prescription lenses may be required despite previous refractive surgery.

Pilots and controllers should be aware that there are requirements for ingoing optometry surveillance following laser and refractive eye surgery.

This guidance should be used for applicants with refractive disorders who have keratorefractive procedures and excludes intracorneal and phakic intraocular implants (see cataract guidelines).

Pilot and controller information

• Pilots and controllers should Inform their ME prior to undertaking refractive eye surgery.
• Pilots and controllers should ground themselves at the time of the surgery.
• Pilots and controllers should not fly or operate until cleared by CAA AvMed following surgery.

For more information, see Medical Manual: Refractive eye surgery.