Merged: LASIK, CASA and CAA-NZ

[nomorecatering]

Does anyone know how long it takes to ri-instate our medical (Class 1) after undergoing the LASIK procedure.

Just read that NASA now accepts the newest laser only method of LASIK for its astronaut core.

[Dubya]

Call CASA..

but I had mine re-instated after 3 weeks (it coincided with holidays), and that was back in 1997....
Should be no problems.

[RadioSaigon]

I've searched and read the relevant threads here, as I have searched the CASA and CAA-NZ sites for information. The threads here are quite encouraging wrt having this procedure done. However, before I start down this track, I would like to see a definitive position from both CASA and CAA-NZ (I hold professional documents in both states). Searches of their respective sites have failed to throw up even an opinion document on the procedures. It may be that my search criteria were inadequate, although I did try a few assorted searches on both sites.

Has anyone here found any such position papers from these authorities that can provide a link for me please? I have failed miserably to find any definitive answers to their position on these procedures, what pre/post-operative requirements there may be, recommended practitioners or procedures or what effect the procedures will have on Class 1 medical certificates.

Would appreciate any links or contacts that may provide the definitive answers.

[Massey058]

Why don't you try and contact a Class 1 AME? Dr Dave Baldwin the Flying Doctor is both a CASA and CAA NZ AME, from memory I don't think he's done an article covering LASIK in the Pacific Wings but he's probably the best person to ask.

[email protected]

058

[Lasiorhinus]

Here's a post I made on another thread a couple of weeks ago regarding this.

In Australia at least, it's absolutely OK - i had Lasik well before I got my student licence - its never been a problem.

But DONT limit yourself to getting the procedure done by a DAO. I dont know if any of the good surgeons are actually DAOs or not - but if you're contemplating LASIK,

GET THE BEST SURGEON IN THE COUNTRY and dont even contemplate letting anyone but the best get anywhere near your eyes with that blade or that laser beam.
Theyre your only set of eyes!!

For the record, my extensive research led me to Grant Snibson, in Royal Parade, Melbourne, as the best in the business. Avoid that certain operator who advertises with big billboards, and who's initials remind people of certain small chocolates. Its no coincidence that he is notorious among the opthamologists of the country.

Do your research, because theres a couple of variations of the procedure in common use, too, and depending on which one you go for will greatly affect your recovery time. They each have their advantages and disadvantages - mainly to do with risks, both during the procedure and subsequent,but also to do with patient comfort.
Theres a new technology, "no-touch", that has been developed since i had mine done, which apparently combines the best bits of the PRK and LASIK while reducing the negative effects of both.

Feel free to PM me if you want to know anything more about the whole deal.

[RadioSaigon]

Yeah thanks Lasiorhinus, I did see & read your previous post -and have taken the advice offered on-board.

What I'm after though is a definitive statement from CASA/CAA-NZ of their position in regards the procedure and their requirements pre/post-operative. I've had a chat to my own DAME, amongst others and have discovered an alarming lack of consistency in their interpretation of whatever advice they have been offered by the regulators. That shouldn't surprise me I know, but it does trigger a master-caution! I'm not going to proceed until I have clear and definitive advice from the respective regulators. To date, no one has been able to show me any documentation in support or otherwise of their interpretation of the regulators' position.

[QFcaptain]

It's not about casa allowing it or not because that's either a simple yes or a no but rather it's about Airlines.I'm not too sure an Airline would consider someone who is aged under 25ish and who has had LASIK, a competitive candidate.

..spray homey

[RadioSaigon]

...aged under 25ish... It has been many years since I saw the sunny-side of even 30-ish, airlines don't interest me -the regulator does and again it is definitive information I am after -or links to where I may find that, rather than opinion.

[RadioSaigon]

ok I'll bite: wtf does "spray homey" mean?

[QFcaptain]

If I told you then I'd have to kil you:eek:

[Lasiorhinus]

CASA Designated Aviation Medical Examiners Handbook, December 2003, Section 2.1.4
http://www.casa.gov.au/manuals/regulate/dame/080r0201.pdf

The role of radial keratotomy in reducing refractive errors is a significant current issue in aviation medicine. Persons who have undergone this procedure are often subject to diurnal fluctuation in visual acuity. If this is significant, (i.e. loss of more than one Snellen line for professional licence applicants and more than two Snellen lines for private licence applicants) even if an applicant’s visual acuity is still within the pass standard, this fluctuation constitutes failure to meet the visual requirements of the standard(s) concerned.
Applicants who undergo radial keratotomy before their myopia has stabilised are at risk of continuing progression of their myopia.
The long-term consequences of radial keratotomy are not yet well documented, so it is impossible to predict any long-term implications for pilot licensing. Applicants should be reminded of this uncertainty as it may affect their chances of employment in the aviation industry.
Following radial keratotomy, the refraction takes some time to stabilise to its new value.
Flying is not permitted while the refraction is still plastic. Evidence of stability requires:
 A variation not exceeding 0.25 dioptres in refraction
 A visual acuity changing by not more than one Snellen line
 Visual acuity, which at least satisfies the minimum standard for the class of licence, at three paired serial measurements.
These three paired serial measurements are to be part of a full ophthalmological examination, are to include measurements early in the morning and late in the day, and must be delayed for at least three months following surgery. Note that some eyes may not have stabilised even as late as a year after surgery.
A second problem associated with radial keratotomy is sensitivity to glare. This can cause considerable difficulty in the healing phase but tends to settle with time. Testing of visual performance with a bright light shining at the applicant should demonstrate any continuing glare sensitivity.
All applicants whose eyes have stabilised following radial keratotomy must thereafter have an ophthalmological assessment every two years for Class 1 and 3 and every five years for Class 2 Medical Certificates.

Photo-ablative Refractive Keratectomy (PRK)
This is a new technique, using a laser, for changing refraction. The long-term implications are as yet unknown. The requirements for assessing stability after radial keratectomy outlined above should be followed after photo-ablative refractive keratectomy.

[RadioSaigon]

Brilliant Lasiorhinus, thank you! :ok: A step in the right direction!

I note with interest the requirement for biennial ophthalmologist reports... CAA-NZ used to make me do that annually (years ago) because I wear contact lenses, until my ophthalmologist wrote a report stating it was an utter waste of his time & my money!

I wonder, those of you that have undergone this procedure, have any issues been discovered in your biennial inspections? Are you happy with the results of the surgery?

[Lasiorhinus]

My own surgery was LASIK, about ten years ago, and according to my regular optometrist AND my DAO, there is no way of telling, from looking at my eyes, that I've had any surgery at all. I had a similar letter on my behalf which has absolved me from these biennial checkups.

[RadioSaigon]

To add a little recent information to this discussion...

If a person undergoes LASIK, what we need to see is that she has completed her recovery post surgery. So what we would need to have are the following:

·A preoperative vision assessment
·Operation notes
·A post operative vision assessment after about 9-12 weeks with special reference to glare and haze.

If the person then meets the standards, she can have a Class 1 certificate.

She would need to have some on going surveillance (she would need to see an optometrist) for the next few years.

Does that answer your question?



The sexist presumption that the candidate in question is female is solely the responsibility of the SMO that authored the reply -IMO a stunning assumption coming from one in a position of responsibility within the oh-so Politically Correct NZ government hierarchy.

[Peter Fanelli]

Photo-ablative Refractive Keratectomy (PRK)
This is a new technique, using a laser, for changing refraction. The long-term implications are as yet unknown. The requirements for assessing stability after radial keratectomy outlined above should be followed after photo-ablative refractive keratectomy.


I also saw this text when researching the subject. Seems to me CASA is a little behind the times on the subject.

[Flash_11]

I had the procedure done in Perth in October 2007 and have just been cleared to fly again after my 3 month grounding and being cleared. In Perth at the Lions eye institute they now use a laser to cut the corneal flap as opposed to the old procedure of using the keratome machine this helps in healing process. Wish I could have afforded this a few years ago.

[Flash_11]

You have to wait 3 months after the surgery before you can be cleared to fly again.

[Flash_11]

Not according to to my DAME, and also after speaking with CASA directly.

Also refer DAME manual 2.1.4 Refractive Surgery

"These three paired serial measurements are to be part of a full ophthalmological
examination, are to include measurements early in the morning and late in the day, and
must be delayed for at least three months following surgery. Note that some eyes may
not have stabilised even as late as a year after surgery."

[Flash_11]

no probs:)