1. 2012.10.01-ME5888

2. Night Carrier Operations

3. Spectacles 2012.10.01-ME5888

4. Soft Contact Lens 2012.10.01-ME5888

5. Contact Lenses

6. Is LASIK OK in the Aerospace Environment? 2012.10.01-ME5888

7. “Retention” Study 785 aviators treated with PRK >45,000 flight hours >12,000 landings Refractive Surgery in Naval Aviators 2012.10.01-ME5888

8. Complications Corneal haze (9 aviators) –Late haze with loss of best vision –Treated with steroids –Grounded but all eventually resumed flying 2012.10.01-ME5888

9. Students allowed into flight training that previously underwent PRK “Accessioning” Study 2012.10.01-ME5888

10. 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 2012.10.01-ME5888

11. These two studies profoundly changed DoD vision standards 2012.10.01-ME5888

12. 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! 2012.10.01-ME5888

13. Is the Flap Stable Enough? 2012.10.01-ME5888

14. Gun Chamber Pressure (lbs/in 2 ) Halo 400 knot ejection Flap Displacement Force Gauge (lbs) 2012.10.01-ME5888

15. Is the Quality of Vision good enough? 2012.10.01-ME5888

16. Change in 5% Contrast Acuity LogMAR Acuity 20/32 20/40 20/32 20/40 PRK LASIK High myopia Moderate Low 2012.10.01-ME5888

17. Wavefront Guided LASIK 2012.10.01-ME5888

18. Loss of ≥ 2 Lines: Conv13% WFG1.1% p=0.00 Conventional vs WFG LASIK WFG provides better Contrast Acuity 2012.10.01-ME5888

19. 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 2012.10.01-ME5888

20. Loss of ≥ 2 Lines: Mech3.1% Femto1.1% p=0.00 Mech Keratome vs Femtosecond Femto provides better Contrast Acuity 2012.10.01-ME5888

21. 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 2012.10.01-ME5888

22. Improving Outcomes WFG WFGFourier MSE Standard Deviation Year 50% 100% 75% % 20/16 UCVA Star S3 Star S2 n = 1168 3 mo postop 2012.10.01-ME5888

23. Comparison of Night Driving Performance After Wavefront- Guided and Conventional LASIK 2012.10.01-ME5888

24. 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 2012.10.01-ME5888

25. LASIK “Best of the Best” Create the LASIK flap with a femtosecond laser Correct refractive error with WFG ablation 2012.10.01-ME5888

26. Optical Express 1 mo. UCVA after iLASIK (24,928 eyes of 13,283 consecutive pts) Age: 18 to 69 yrs Sph: -0.25 to -6.0D Cyl: 0.0 to -6.0D 2012.10.01-ME5888

27. First Naval Aviator to undergo LASIK 2012.10.01-ME5888

28. 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 2012.10.01-ME5888

29. We have entered a new era in laser vision correction 2012.10.01-ME5888