民航飞行员白内障患病率调查及航空医学鉴定

Prevalence of cataract in Chinese civil aviation pilots and aeromedical appraisal

目的 调查民航飞行员白内障患病率,探讨其航空医学鉴定. 方法 收集2009年5月至2010年4月民航飞行员眼科检查资料,分析白内障患病特点和4例白内障摘除联合人工晶状体植入术后特许飞行合格飞行员的随访资料.不同年龄组飞行员白内障检出率比较采用卡方检验. 结果民航飞行员白内障检出率为0.28％,患病年龄21～67岁,不同年龄组之间白内障检出率差异有统计学意义(x2 =217.737,P＜0.01),40岁以上飞行员白内障检出率随年龄逐渐升高.晶状体混浊部位以皮质性混浊为主.4例特许飞行合格飞行员白内障摘除联合人工晶状体植入术后视功能良好,特许合格以来已累计安全飞行1300～4000 h,无空中不适及事故征候. 结论 我国民航飞行员目前白内障检出率较低,但患病率有随年龄升高的趋势.白内障飞行员出现视物模糊、视力下降、视功能受损时应临时停飞治疗,术后观察3个月,进行航空医学鉴定时若视功能良好,无影响飞行安全的并发症,可考虑特许飞行合格；特许飞行随访3～4年,若视功能稳定,特许飞行安全,无事故征候,可考虑飞行合格.

Objective To investigate the prevalence of cataract in Chinese civil aviation pilots and to discuss the aeromedical appraisal.Methods The data of annual ocular examination of pilots from May 2009 to April 2010 were collected.The characteristics of cataract and the follow-up data of 4 waiver cases after cataract extraction combined with intraocular lens implantation were analyzed.Results The cataract prevalence in civil aviation pilots (aged from 21-67 years old) was 0.28％.The prevalence among different age groups had significant difference (x2=217.737,P＜0.01).The cataract positive rate of the pilots older than 40 years old was gradually increased.The opacity mainly located in the lens cortex.The visual function in 4 waiver cases treated by cataract extraction combined with intraocular lens implantation was good.Their safe flying time had been accumulated to 1300-4000 h without discomfort in air since the waiver issued.Conclusion The prevalence of cataract of Chinese civil aviation pilots is low but shows an increasing tendency with age.Cataract pilot who suffered blurred vision,decreased visual acuity and function damage should be temporarily grounded and treated.Special qualification could be considered if pilot's visual function is good,stable and without any complications affecting the flight safety according to 3 month postoperative observation.If the special qualification does not lead to any threads to flight safety and the pilot could keep stable visual function by 3-4 years follow-up,he would get the qualification without limitation.