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Introduction: Photorefractive Keratectomy (PRK) and Laser-Assisted in Situ
Keratomileusis (LASIK) are widely applied procedures designed to correct refractive
errors in adults. While there is evidence of the safety and effectiveness of these
surgeries, long-term visual and refractive outcomes in combat pilots have not been
thoroughly studied. This study aims to investigate the long-term effects of PRK and
LASIK on Israeli Air Force aviators, thereby providing essential insights into how
these procedures impact their performance.
Methods: Medical records of aviators who underwent refractive surgery during their
service were extracted. Preoperative and annual postoperative data were analyzed.
Key metrics included visual acuity (VA) and spherical equivalent (SE).
Results: 87 records were analyzed. Mean age at the time of surgery was 31.8±9.8
years; 95.4% of participants were male. Pre-surgery myopia severity (SE) was
-2.060±1.158. LASIK and PRK procedures were performed in 62.1% and 33.3% of the
surgeries, respectively. Both PRK and LASIK demonstrated significant, sustained
improvements in VA for 11 years (p=0.035) and in SE for 12 years (p<0.001). Myopia
severity pre-surgery was identified as a crucial determinant of postoperative
outcomes for VA (p=0.029) and SE (p=0.008). Age, astigmatism, and procedure type
did not significantly affect long-term outcomes.
Conclusions: This study highlights the enduring efficacy of PRK and LASIK for
aviators. The outcome is highly affected by the severity of preoperative myopia,
emphasizing the need for individualized assessments prior to the procedure
and consistent follow-ups afterward. These findings reinforce the safety and
effectiveness of PRK and LASIK in high-demand jobs, providing essential guidance
for healthcare providers in making refractive surgery decisions.