招飞体检中对屈光性角膜手术眼的识别与医学鉴定

Detection of keratorefractive operation eyes in physical examination of flying cadet candidates and its medical assessment

目的 在招飞体检中用不同检查方法对接受屈光性角膜手术者进行甄别并探讨屈光性角膜手术对飞行工作的影响。 方法 通过对 1894例 (3788只眼 )男性高中毕业生扩瞳后电脑验光检查、带状光检影镜检查、聚光灯照射法检查、裂隙灯检查、检眼镜彻照法检查及眼底检查 ,比较其对屈光性角膜手术者的识辩率。并着重对RK、PRK、LASIK 3种手术对飞行工作的影响进行了探讨。 结果 在招飞体检现有的体检器材中 ,带状光检影镜检查法对屈光性角膜手术的识别率最高 ,其次为检眼镜彻照法和裂隙灯检查法。 结论 屈光性角膜手术后的并发症及后遗症破坏了角膜对眼球的保护作用 ,影响了原有的视觉功能 ,难以胜任飞行工作。招飞体检中对RK、PRK手术者应淘汰 ;对小度数LASIK手术一年以上者、视觉功能正常 ,民用机、直升机、轰炸机可合格。

Objective To explore the optimum method for detecting eyes underwent keratorefractive operations, including radial keratotomy (RK), photorefractive keratotomy (PRK) and laser assisted in situ keratomileusis (LASIK), and discuss the possible effects of these operations on flying duties. Methods Computer optometry, streak retinoscopy, projection lamp radiation examination, slit lamp microscopy, ophthalmoscopic transillumination and fundus examination were use to examine mydriatic eyes of 1894 candidates to select the optimum method for detecting keratorefractive operation eye. Results Streak retinoscopy revealed all the 31 eyes (16 candidates) underwent keratorefractive operation in this sample of candidates, while other methods can’t. Conclusion Streak retinoscopy is the best way for detecting keratorefractive operation eyes. Considering the complications and sequelaeof various keratorefractive operations, it is suggested that candidates underwent PK or PPK should be eliminated, and those underwent LASIK more than 1 year before with normal visual function may be qualified as student pilots of civil aviation, helicopters and bombers.