%PDF-1.2
%
2 0 obj
<<
/Length 1144
>>
stream
BT
/F1 1 Tf
11 0 0 11 72 710.76 Tm
0 0 0 1 k
/GS2 gs
0.0242 Tc
0 Tw
(DOT/FAA/AM-02/10)Tj
18.2727 -11.5964 TD
0.0233 Tc
-0.0023 Tw
(Van B. Nakagawara)Tj
0 -1.3636 TD
(Ron W. Montgomery)Tj
T*
0.023 Tc
0.0022 Tw
(Kathryn J. Wood)Tj
T*
0.0234 Tc
0.006 Tw
(Civil Aerospace Medical Institute)Tj
T*
0.0237 Tc
0.0046 Tw
(Federal Aviation Administration)Tj
T*
0.0232 Tc
(Oklahoma City, OK 73125)Tj
0 -4.0909 TD
0.0234 Tc
-0.0045 Tw
(June 2002)Tj
0 -8.1818 TD
-0.0136 Tw
(Final Report)Tj
0 -13.6364 TD
0.0232 Tc
0.0053 Tw
(This document is available to the public)Tj
0 -1.3636 TD
0.0023 Tw
(through the National Technical Information)Tj
T*
0.0235 Tc
0 Tw
(Service, Springfield, VA 22161.)Tj
/F2 1 Tf
21 0 0 21 273 704.64 Tm
0.0035 Tc
0.022 Tw
[(The A)37.8(viation A)9.2(ccident)]TJ
0 -1.0971 TD
0.0038 Tc
0.0175 Tw
[(E)8.2(xperience of C)9.5(ivilian Air)20.9(men)]TJ
0 -1.0914 TD
0.0036 Tc
0.0277 Tw
[(W)9.3(ith R)9.3(efractiv)32.2(e S)20.7(u)-0.1(rger)-19.3(y)]TJ
/F1 1 Tf
11 0 0 11 72 674.52 Tm
0.0235 Tc
0.0076 Tw
(Office of Aerospace Medicine)Tj
0 -1.3636 TD
0.0045 Tw
(Washington, DC 20591)Tj
ET
q
1 i
273 162.2 89.8 -90.2 re
W n
/GS1 gs
/Fm2 Do
Q
endstream
endobj
3 0 obj
<<
/ProcSet [/PDF /Text ]
/Font <<
/F1 4 0 R
/F2 5 0 R
>>
/XObject <<
/Fm2 6 0 R
>>
/ExtGState <<
/GS1 7 0 R
/GS2 8 0 R
>>
>>
endobj
10 0 obj
<<
/FunctionType 0
/Domain [0 1]
/Range [0 1]
/BitsPerSample 8
/Size [256]
/Length 271
/Filter /FlateDecode
>>
stream
H
!"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~
endstream
endobj
11 0 obj
<<
/FunctionType 0
/Domain [0 1]
/Range [-1 1]
/BitsPerSample 16
/Size [256]
/Length 527
/Filter /FlateDecode
>>
stream
H
!"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~ ?
endstream
endobj
13 0 obj
<<
/Length 548
>>
stream
BT
/F1 1 Tf
16 0 0 16 241.08 594 Tm
0 0 0 1 k
/GS2 gs
0.6336 Tc
0 Tw
[(NO)33.6(TICE)]TJ
14 0 0 14 115.44 545.4 Tm
0.0755 Tc
0.0133 Tw
(This document is disseminated under the sponsorship of)Tj
-0.0343 -1.1486 TD
0.0753 Tc
0.01 Tw
[(the U.S. Depar)-10.4(tment of )41.2(T)126.7(ranspor)-10.4(tation in the inter)6.7(est of)]TJ
0.6343 -1.14 TD
0.0751 Tc
0.0114 Tw
[(information ex)6.5(change. )49.4(The U)40.8(nited S)15.1(tates G)6.5(o)12.5(v)10(ernment)]TJ
2.1086 -1.14 TD
0.0757 Tc
[(assumes no liability for the contents ther)7.1(eof)7.1(.)]TJ
ET
endstream
endobj
14 0 obj
<<
/ProcSet [/PDF /Text ]
/Font <<
/F1 4 0 R
>>
/ExtGState <<
/GS2 8 0 R
>>
>>
endobj
15 0 obj
<<
/Length 757
>>
stream
Microsoft Word - 1700.doc
endstream
endobj
18 0 obj
<<
/Length 17937
>>
stream
BT
/F1 1 Tf
12 0 0 12 316.2 36.96 Tm
0 0 0 1 k
/GS2 gs
0 Tc
0 Tw
(i)Tj
ET
/EmbeddedDocument /MC1 BDC
q
/RelativeColorimetric ri
BT
/F3 1 Tf
8.9993 0 0 8.9995 233.4669 719.8415 Tm
0 0 0 rg
/GS3 gs
0.0021 Tc
-0.0001 Tw
[(Techni)13.4(cal Rep)13.1(o)-0.2(rt Docum)11.1(entati)13.4(on Pag)13.1(e)]TJ
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 705.6824 Tm
-0.0011 Tc
0 Tw
[(1. Re)-6.3(p)-8.8(o)-18.6(r)6.8(t)-7( No.)-15587.3(2. G)-8.5(o)-1.3(ve)-23.6(r)6.8(n)-11.8(m)5.8(e)-6.3(n)5.4(t)-7( )-17.2(Ac)-9.3(c)-9.3(e)-6.3(s)-9.7(s)-9.7(i)-8(on)5.4( No.)-9569.6(3. Re)-6.3(c)-9.3(i)-8(p)-8.8(i)-8(e)-6.3(n)5.4(t)-7(')7.2(s)-9.7( Ca)-7.8(t)-7(a)-7.8(l)-8(o)-1.3(g No.)]TJ
ET
81.68 713.002 474.681 -0.72 re
f
555.641 713.002 0.72 -0.72 re
f
81.68 712.282 0.72 -8.28 re
f
235.987 712.282 0.72 -8.28 re
f
405.533 712.282 0.72 -8.28 re
f
555.641 712.282 0.72 -8.28 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 694.763 Tm
-0.0012 Tc
(DOT/FAA/AM-02/10)Tj
ET
81.68 704.123 0.72 -23.999 re
f
235.987 704.123 0.72 -23.999 re
f
405.533 704.123 0.72 -23.999 re
f
555.641 704.123 0.72 -23.999 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 672.6843 Tm
0.0057 Tc
-0.0068 Tw
[(4)7.9(.)6.8( Title an)12.2(d Su)10.2(btitle)]TJ
46.5377 0 TD
-0.0019 Tc
0.0008 Tw
[(5. Re)-7.1(p)-9.6(o)-19.4(r)6(t)-7.8( Da)-8.6(t)-7.8(e)]TJ
ET
81.68 680.124 474.681 -0.72 re
f
81.68 679.404 0.72 -8.28 re
f
405.533 679.404 0.72 -8.28 re
f
555.641 679.404 0.72 -8.28 re
f
81.68 671.125 0.72 -6.84 re
f
405.533 671.125 0.72 -6.84 re
f
555.641 671.125 0.72 -6.84 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 458.6883 654.9254 Tm
-0.0007 Tc
0.0007 Tw
(June 2002)Tj
ET
81.68 664.285 0.72 -12.359 re
f
405.653 664.285 0.48 -12.359 re
f
555.641 664.285 0.72 -12.359 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 411.2921 644.606 Tm
-0.0041 Tc
0.003 Tw
[(6. Pe)-26.6(rfo)-21.6(r)-13.5(m)1.5(i)-11(n)1.5(g)-3.6( )-17.2(O)-14.5(r)3.8(g)-3.6(a)-10.8(ni)-11(z)-10.2(a)-10.8(t)-10(i)-11(o)-4.3(n)2.4( C)-18.7(o)-4.3(d)-8.8(e)]TJ
ET
81.68 651.926 0.72 -0.72 re
f
405.653 651.926 150.708 -0.72 re
f
81.68 651.206 0.72 -11.519 re
f
405.653 651.206 0.48 -11.519 re
f
555.641 651.206 0.72 -11.519 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 654.9254 Tm
0.0016 Tc
-0.0016 Tw
[(Th)5.7(e)6.3( A)5(v)-1.2(iati)8.6(o)-0.7(n)4.9( A)5(cci)8.6(de)6.3(n)4.9(t)4.2( Ex)9.7(pe)6.3(rie)6.3(n)4.9(c)-0.7(e)6.3( )10.9(of C)12.8(i)-2.3(vi)8.6(lian)4.9( A)15.9(i)-2.3(rm)6(e)6.3(n)4.9( W)5.1(i)-2.3(th)5.7( R)5.3(e)6.3(fra)14.3(ctive)]TJ
0 -1.1087 TD
0.0007 Tc
0 Tw
(Surgery)Tj
ET
81.68 639.686 0.72 -11.519 re
f
405.653 639.686 0.48 -11.519 re
f
555.641 639.686 0.72 -11.519 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 620.8474 Tm
-0.0034 Tc
0.0023 Tw
[(7. Aut)-26.5(ho)-20.9(r)4.5(\()-0.6(s)-12(\))]TJ
46.5377 0 TD
-0.0043 Tc
0.0032 Tw
[(8. Pe)-26.8(rfo)-21.8(r)-13.7(m)1.3(i)-11.2(n)1.3(g)-3.8( )-17.2(O)-14.7(r)3.6(g)-3.8(a)-11(ni)-11.2(z)-10.4(a)-11(t)-10.2(i)-11.2(o)-4.5(n)2.2( Re)-9.5(p)-12(o)-21.8(rt)-10.2( N)-5.7(o)-4.5(.)]TJ
ET
81.68 628.167 474.681 -0.72 re
f
81.68 627.447 0.72 -11.519 re
f
405.533 627.447 0.72 -11.519 re
f
555.641 627.447 0.72 -11.519 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 606.6883 Tm
-0.0005 Tc
0.0005 Tw
[(Nakagawara, V.)10.4(B., M)9.3(o)-3.6(ntgomery, R.W.,)10.4( and Wo)7.2(od, K.)10.4(J.)]TJ
ET
81.68 615.928 0.72 -23.999 re
f
405.533 615.928 0.72 -23.999 re
f
555.641 615.928 0.72 -23.999 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 584.6097 Tm
-0.0009 Tc
-0.0002 Tw
[(9. Pe)-23.4(r)7(f)2.7(o)-18.4(r)-10.3(m)6(i)-7.8(n)5.6(g)-0.4( )-17.2(O)-11.3(r)7(ga)-7.6(n)5.6(i)-7.8(z)-7(a)-7.6(t)-6.8(i)-7.8(on)5.6( Na)-24.8(m)6(e)-6.1( a)-7.6(n)5.6(d)-5.6( Ad)-5.6(d)-22.8(r)7(e)-6.1(s)-9.5(s)-23614.6(10. W)-6.5(o)-18.4(r)7(k)1.1( )-17.2(Un)5.6(i)-7.8(t)-6.8( No. )-17.2(\()6(T)-6(RA)-19.6(IS\))]TJ
ET
81.68 591.929 474.681 -0.72 re
f
81.68 591.209 0.72 -12.359 re
f
405.533 591.209 0.72 -12.359 re
f
555.641 591.209 0.72 -12.359 re
f
81.68 578.85 0.72 -11.519 re
f
405.533 578.85 0.72 -11.519 re
f
555.641 578.85 0.72 -11.519 re
f
81.68 567.451 0.72 -12.359 re
f
405.533 567.451 0.72 -12.359 re
f
555.641 567.451 0.72 -12.359 re
f
BT
6.9589 0 0 6.9591 411.2921 547.6519 Tm
-0.0015 Tc
0.0004 Tw
[(11. )-17.2(Cont)-24.6(r)6.4(a)-8.2(c)-9.7(t)-7.4( or)6.4( G)-26.1(r)6.4(a)-8.2(n)5(t)-7.4( No.)]TJ
ET
81.68 555.092 0.72 -0.72 re
f
405.533 555.092 150.828 -0.72 re
f
81.68 554.372 0.72 -11.519 re
f
405.533 554.372 0.72 -11.519 re
f
555.641 554.372 0.72 -11.519 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 569.6107 Tm
-0.0033 Tc
0.0033 Tw
[(FAA Ci)-7.2(v)-6.1(i)-7.2(l)-6.3( Ae)12.3(r)-8.3(o)-6.4(sp)-7.2(ac)-5.5(e Med)5.7(i)-7.2(c)-5.5(al Ins)-6.4(ti)-7.2(tute)]TJ
0 -1.1196 TD
0.0009 Tc
-0.0118 Tw
[(P.O. Box)9( )-10.9(25082)]TJ
T*
-0.0007 Tc
0.0007 Tw
[(Oklahoma City, OK 7)10.2(3125)]TJ
ET
81.68 542.852 0.72 -11.519 re
f
405.533 542.852 0.72 -11.519 re
f
555.641 542.852 0.72 -11.519 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 523.8933 Tm
-0.0013 Tc
0.0002 Tw
[(12. Sp)-9(o)-18.8(n)5.2(s)-9.9(o)-1.5(r)6.6(i)-8.2(n)-12(g)-0.8( Age)-23.8(n)5.2(c)-9.5(y )-17.2(n)5.2(a)-8(m)5.6(e)-6.5( a)-25.2(n)5.2(d)-6( Ad)-6(d)-6(r)6.6(e)-6.5(s)-9.9(s)-25563.4(13. T)-6.4(y)0.2(p)-9(e)-6.5( o)-18.8(f)2.3( Re)-6.5(p)-9(o)-18.8(r)6.6(t)-7.2( a)-8(n)5.2(d)-6( )-17.2(Pe)-6.5(r)6.6(i)-8.2(od)-6( )-17.2(Cove)-23.8(r)6.6(e)-6.5(d)]TJ
ET
81.68 531.333 474.681 -0.72 re
f
81.68 530.613 0.72 -12.359 re
f
405.533 530.613 0.72 -12.359 re
f
555.641 530.613 0.72 -12.359 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 508.8942 Tm
0.0019 Tc
-0.0019 Tw
[(Offi)8.9(ce)6.6( of A)5.3(e)17.5(ros)9.7(pace)6.6( Me)6.6(d)10.9(i)-2(c)10.6(i)-2(n)5.2(e)]TJ
ET
81.68 518.254 0.72 -12.359 re
f
405.533 518.254 0.72 -12.359 re
f
555.641 518.254 0.72 -12.359 re
f
BT
11.0391 0 0 11.0393 87.4391 496.6549 Tm
0.0017 Tc
-0.0017 Tw
[(F)7.1(e)6.4(de)6.4(ral A)5.1(v)-1.1(iati)8.7(o)-0.5(n)5( A)5.1(d)-0.2(m)6.1(i)-2.2(n)15.8(i)-2.2(strat)15.2(ion)]TJ
ET
81.68 505.894 0.72 -12.359 re
f
405.533 505.894 0.72 -12.359 re
f
555.641 505.894 0.72 -12.359 re
f
BT
11.0391 0 0 11.0393 87.4391 484.2957 Tm
-0.0012 Tc
0.0012 Tw
(800 Independence Ave, S.W.)Tj
ET
81.68 493.655 0.72 -12.359 re
f
405.533 493.655 0.72 -12.359 re
f
555.641 493.655 0.72 -12.359 re
f
BT
11.0391 0 0 11.0393 87.4391 471.2164 Tm
-0.0005 Tc
0.0005 Tw
[(Washington, D)7.8(C)-0.2( 20591)]TJ
/F4 1 Tf
6.9589 0 0 6.9591 411.2921 473.8563 Tm
-0.0007 Tc
-0.0004 Tw
[(14. Sp)-8.4(o)-18.2(n)5.8(s)-9.3(o)-0.9(r)7.2(i)-7.6(n)-11.4(g)-0.2( Age)-23.2(n)5.8(c)-8.9(y C)-15.3(o)-0.9(d)-5.4(e)]TJ
ET
81.68 481.296 0.72 -0.72 re
f
405.533 481.296 150.828 -0.72 re
f
81.68 480.576 0.72 -12.359 re
f
405.533 480.576 0.72 -12.359 re
f
555.641 480.576 0.72 -12.359 re
f
81.68 468.217 0.72 -12.359 re
f
405.533 468.217 0.72 -12.359 re
f
555.641 468.217 0.72 -12.359 re
f
BT
6.9589 0 0 6.9591 87.4391 448.5378 Tm
0.0055 Tc
-0.0066 Tw
[(1)7.7(5)7.7(.)6.6( S)-13.8(u)10(pplem)12.4(en)12(tal Notes)]TJ
ET
81.68 455.977 474.681 -0.72 re
f
81.68 455.257 0.72 -12.359 re
f
555.641 455.257 0.72 -12.359 re
f
81.68 442.898 0.72 -11.519 re
f
555.641 442.898 0.72 -11.519 re
f
BT
6.9589 0 0 6.9591 87.4391 423.9392 Tm
-0.0008 Tc
-0.0003 Tw
[(16. Ab)-8.5(s)-9.4(t)-6.7(r)7.1(a)-7.5(c)-9(t)]TJ
ET
81.68 431.379 474.681 -0.72 re
f
81.68 430.659 0.72 -12.359 re
f
555.641 430.659 0.72 -12.359 re
f
BT
/F5 1 Tf
11.0391 0 0 11.0393 87.4391 408.8202 Tm
-0.0037 Tc
0 Tw
[(I)-8.4(n)-3.3(t)-8.8(r)-2.5(odu)5.4(c)-5.9(t)0(i)-7.4(o)0(n)]TJ
/F1 1 Tf
5.087 0 TD
0.0019 Tc
-0.0019 Tw
[(: C)13.1(i)-2(vi)8.9(l ai)8.9(rm)6.3(e)6.6(n)5.2( with)6( )10.9(re)6.6(fra)14.6(ctive)6.6( s)9.7(u)3(rge)6.6(ry)5.1( m)6.3(a)3.7(y)5.1( )10.9(obtain)5.2( an)5.2(y)5.1( clas)9.7(s )10.9(of F)7.3(e)6.6(de)6.6(ra)14.6(l A)5.3(v)-0.9(iat)15.4(ion)5.2( A)5.3(d)0(m)6.3(i)-2(n)16(i)-2(st)15.4(ration)]TJ
-5.087 -1.1196 TD
-0.0037 Tc
0.0037 Tw
[(\(FAA\) m)-10.2(e)1(d)-5.6(i)-7.6(c)-5.9(a)-1.9(l)-6.7( c)-5.9(e)11.9(r)-8.7(t)-1(i)-7.6(f)3.7(i)-7.6(c)-5.9(ate pr)-8.7(ov)-6.5(i)-7.6(d)-5.6(ed)-5.6( they meet the ap)-7.6(p)-7.6(l)-6.7(i)-7.6(c)-5.9(a)9(b)-3.7(l)-6.7(e)1( vi)-7.6(s)-6.8(i)3.3(o)-6.8(n)-0.4( s)-6.8(t)-1(and)-5.6(a)9(r)-8.7(d)-5.6(s, and)-5.6( an eye s)-6.8(p)-7.6(eci)-7.6(al)-6.7(is)-6.8(t v)-6.5(e)1(ri)-7.6(fi)-7.6(es)]TJ
T*
-0.0023 Tc
0.0023 Tw
[(that heali)-6.2(ng i)-6.2(s)-5.4( c)6.4(o)-5.4(mp)-6.2(lete, v)5.8(i)-6.2(sual a)10.4(c)-4.5(uity is)-5.4( s)-5.4(t)0.4(ab)8.6(l)-5.3(e)2.4(, and no)-5.4( )10.9(s)-5.4(i)-6.2(gnif)-5.8(icant gl)-10.4(ar)-7.3(e )10.9(i)-6.2(n)1(to)-5.4(l)-5.3(e)2.4(r)-7.3(a)-0.5(n)11.8(c)-4.5(e i)-6.2(s)-5.4( )10.9(p)-6.2(r)-7.3(es)-5.4(ent. H)10.2(o)-5.4(w)-5.3(e)2.4(v)-5.1(e)2.4(r,)]TJ
0 -1.1087 TD
-0.0031 Tc
0.0031 Tw
[(c)-5.3(o)-6.2(nc)-5.3(er)-8.1(n)11(s)-6.2( r)-8.1(e)1.6(mai)-7(n )10.9(r)-8.1(e)1.6(gar)-8.1(d)5.9(i)-7(ng the q)-6.1(u)-2(ali)-7(ty o)-6.2(f)-6.6( the r)-8.1(e)1.6(s)-6.2(u)8.9(l)-6.1(t)-0.5(i)-7(n)0.2(g )10.9(r)-8.1(e)1.6(f)-6.6(r)-8.1(a)9.6(c)-5.3(ti)-7(v)-5.9(e)1.6( co)-6.2(rr)-8.1(ec)-5.3(tio)-6.2(n, lo)-6.2(ng-ter)-8.1(m s)-6.2(t)-0.4(abil)-6.1(i)-7(t)-0.4(y, si)-7(d)-5(e)1.6( ef)-6.6(f)-6.6(e)1.6(c)-5.3(t)10.4(s)-6.2(,)]TJ
0 -1.1196 TD
0.0021 Tc
-0.0021 Tw
[(an)5.4(d t)4.8(h)6.2(e)6.8( pot)4.8(e)6.8(n)5.4(t)4.8(ial su)14.1(rgi)9.1(cal c)10.8(o)-1(m)6.5(p)9.1(licat)15.6(ion)5.4(s)-0.3( a)14.8(s)-1(s)9.9(o)-1(ciat)4.8(e)6.8(d)0.2( )10.9(wit)4.8(h)6.2( )10.9(re)6.8(fra)14.8(ctive)6.8( su)14.1(rge)6.8(ry)5.3(. )10.9(Th)6.2(e)6.8( pu)14.1(rp)9.1(ose)6.8( o)9.8(f)-1.4( t)4.8(h)6.2(is )10.9(st)4.8(udy)5.3( wa)14.8(s to)]TJ
0 -1.1304 TD
-0.0031 Tc
0.0031 Tw
[(d)-5(e)1.6(ter)-8.1(mi)-7(ne w)-6.1(h)1(ether)-8.1( an as)-6.2(s)-6.2(o)4.6(c)-5.3(i)-7(atio)-6.2(n ex)-5.9(is)-6.2(ted)-5( betw)-6.1(een r)-8.1(e)1.6(f)-6.6(r)-8.1(a)9.6(c)-5.3(ti)-7(v)-5.9(e)1.6( sur)-8.1(ger)-8.1(y)0.3( an)11(d)-5( av)-5.9(i)-7(a)-1.3(t)10.4(i)-7(o)-6.2(n)0.2( acc)-5.3(id)-5(ents)-6.2(. )]TJ
/F5 1 Tf
35.163 0 TD
0.002 Tc
0 Tw
[(Met)7.8(ho)4.9(d)4.1(s)]TJ
/F1 1 Tf
3.5217 0 TD
0 Tc
(:)Tj
-38.6848 -1.1196 TD
-0.0001 Tc
-0.0001 Tw
[(Record)8.9(s f)7.3(o)-3.2(r a)12.6(c)-2.3(tive ai)6.9(rman dur)5.8(ing)5.7( the study )10.7(peri)6.9(od, )10.7(1994-96, )10.9(were extra)12.6(cted f)7.3(r)-5.1(om the F)5.3(AAs Con)14(sol)7.8(idated)]TJ
0 -1.1087 TD
0.0018 Tc
-0.0018 Tw
[(A)5.2(i)-2.1(rm)6.2(an)5.1( In)5.1(fo)9.5(rm)6.2(at)4.5(i)8.8(o)-1.3(n)5.1( Sy)5(st)4.5(e)6.5(m)6.2( m)6.2(e)6.5(dical )8.1(dat)4.5(abase)6.5(. A)5.2(i)8.8(rm)6.2(e)6.5(n)5.1( wh)5.9(o )10.9(car)7.7(rie)6.5(d)-0.1( )10.9(pat)4.5(h)5.9(o)-0.1(l)16.5(ogy)5( co)9.5(de)6.5(s f)9.2(o)-1.3(r )10.9(re)6.5(fr)7.7(acti)8.8(v)-0.7(e)6.5( sur)7.7(ge)6.5(ry)]TJ
0 -1.1196 TD
-0.0005 Tc
0.0006 Tw
[(\(130\) and general eye )5.3(surgery \(5179\) )11(were i)6.5(d)-2.4(entified. )11(These rec)8.2(or)5.4(ds )11(were)7( cr)5.4(os)7.3(s-referenced )11(with the)]TJ
T*
0 Tc
0 Tw
[(Accide)4.7(nt/Inci)7(de)4.7(nt Data Syste)4.7(m)4.4( database)4.7( to )10.9(de)4.7(te)4.7(rm)4.4(ine)4.7( th)7.6(ose)4.7( ai)]TJ
23.9341 0 TD
0.001 Tc
-0.001 Tw
[(rm)5.4(e)5.7(n)4.3( invo)8.7(lve)5.7(d )10.9(in ai)8(rcra)13.7(ft acc)9.7(i)-2.9(de)5.7(nts. F)6.4(r)-4(e)16.6(q)-2(ue)5.7(ncy)]TJ
-23.9341 -1.1087 TD
-0.0002 Tc
0.0002 Tw
[(totals and mean acc)8.5(ident ra)10.3(tes \(acc)8.5(idents/10)10.7(0,000 )10.9(fli)6.8(ght hour)5.7(s\) were cal)7.7(culated )10.9(fo)7.5(r each cla)12.5(ss o)7.5(f)-3.7( F)5.2(AA medica)12.5(l)]TJ
0 -1.1196 TD
0 Tc
0 Tw
[(certif)7.4(icati)7(on. Analys)7.8(is )10.9(of Va)12.7(riance )]TJ
13.1366 0 TD
-0.0005 Tw
[(wa)12.7(s pe)15.6(rf)7.4(ormed to com)15.3(p)-3.9(a)1.8(r)-5(e)1.8( the mean )]TJ
14.3053 0 TD
-0.0009 Tc
0.0009 Tw
[(acci)-4.8(dent r)-5.9(a)1.6(tes )10.9(of n)13.2(o)-4(n-refra)11.8(cti)-4.8(v)-3.3(e and)]TJ
-27.4418 -1.1304 TD
0.0031 Tc
-0.0031 Tw
[(re)7.8(fra)15.8(ct)5.8(ive)7.8( su)15.1(rge)7.8(r)-1.9(y)6.3( a)15.8(i)-0.8(rm)7.5(e)7.8(n)6.4(. )]TJ
/F5 1 Tf
10 0 TD
-0.0069 Tc
0 Tw
[(Re)-10.9(su)-8.6(lt)-12(s)]TJ
/F1 1 Tf
2.8478 0 TD
0.0016 Tc
-0.0016 Tw
[(: )10.9(Th)5.7(e)6.3( total ac)10.3(cide)6.3(n)4.9(t)4.2( rate)6.3( wa)14.3(s h)5.7(i)-2.3(gh)5.7(e)6.3(r)-3.4( fo)9.3(r)7.5( ai)8.6(rm)6(e)6.3(n)4.9( with)5.7( )10.9(re)6.3(fra)14.3(ctive)6.3( su)13.6(rge)6.3(ry)]TJ
-12.8478 -1.1196 TD
-0.0001 Tc
-0.0108 Tw
[(\(3.86/100,000 fl)7.8(ight )-10.9(hour)5.8(s\) )-10.9(when )-10.9(com)15.2(pared with )-10.9(those without refra)12.6(ctive pr)5.8(ocedu)11.9(r)-5.1(es )-10.9(\(2.62/10)10.8(0,000 fli)6.9(ght)]TJ
0 -1.1087 TD
0.0018 Tc
-0.0018 Tw
[(h)5.9(o)-1.3(urs\))6.6(. A)5.2(c)10.5(cide)6.5(n)5.1(t)4.5( rate)6.5(s)-0.4( )10.9(fo)9.5(r ai)8.8(rm)6.2(e)6.5(n)5.1( with)5.9( )10.9(re)6.5(fra)14.5(ctive)6.5( )10.9(surge)17.4(ry)5( we)6.5(re)6.5( al)9.7(so h)5.9(i)8.8(gh)5.9(e)6.5(r)-3.2( in)5.1( al)9.7(l th)5.9(re)6.5(e)6.5( cla)14.5(sse)6.5(s )10.9(of m)6.2(e)6.5(di)8.8(cal)]TJ
0 -1.2717 TD
[(ce)6.5(rt)4.5(if)9.2(icat)4.5(i)8.8(on)5.1(; h)5.9(o)9.5(we)6.5(ve)6.5(r, an)5.1(aly)5(s)9.6(is )10.9(foun)15.9(d t)4.5(h)5.9(at)4.5( t)4.5(h)5.9(e)6.5(s)-1.3(e)6.5( diffe)17.4(re)6.5(n)5.1(c)-0.4(e)6.5(s)-1.3( we)6.5(re)6.5( n)5.1(o)-1.3(t)4.5( )10.9(st)4.5(at)4.4(ist)15.3(ical)9.7(ly)5( sign)15.9(if)9.2(ican)5.1(t)4.5( \()6.6(p)-2.1( )]TJ
/F6 1 Tf
36.1848 0 TD
0 Tc
0 Tw
(>)Tj
/F1 1 Tf
0.5543 0 TD
0.0003 Tc
-0.0003 Tw
[( 0.)11.2(05\) )10.9(fo)8(r)]TJ
-36.7391 -1.1196 TD
[(any class )10.9(of m)4.8(e)5.1(d)9.4(i)-3.5(cal )10.9(ce)5.1(rti)7.4(f)-3.1(icat)13.9(ion o)8.1(r)-4.6( th)4.5(e)5.1( total a)13.1(i)-3.5(rm)4.8(an p)7.4(o)-2.7(pul)]TJ
22.3806 0 TD
[(ation.)11.3( In add)9.4(ition, )10.9(our)6.3( re)5.1(v)8.5(i)-3.5(e)5.1(w)-2.6( f)7.8(o)-2.7(und no)8.1( aviat)13.9(ion)]TJ
-22.3806 -1.1304 TD
0.0011 Tc
-0.0011 Tw
[(accide)5.9(nt in )10.9(wh)5.3(ich)5.3( )10.9(re)5.9(fra)13.9(ctive)5.9( s)9(u)2.3(rge)16.8(ry was)9( ide)5.9(nti)8.2(fie)5.9(d as)9( a causa)13.9(l fact)14.7(or.)12.1( )]TJ
/F5 1 Tf
26.2935 0 TD
0.0002 Tc
0 Tw
[(Conc)8.9(lus)9.2(ions)]TJ
/F1 1 Tf
4.8696 0 TD
-0.0006 Tc
0.0006 Tw
[(: Altho)7.1(ugh acc)8.1(ident rates o)7.1(f)]TJ
-31.163 -1.1087 TD
-0.0033 Tc
0.0033 Tw
[(r)-8.3(e)1.4(f)-6.8(r)-8.3(a)9.4(c)-5.5(ti)-7.2(v)-6.1(e)1.4( s)-6.4(u)8.7(r)-8.3(g)-3(er)-8.3(y a)9.4(i)-7.2(r)-8.3(m)1.1(en w)-6.3(e)12.3(r)-8.3(e)1.4( hi)-7.2(gher)-8.3(, no)-6.4( )10.9(d)-5.2(i)3.7(r)-8.3(e)1.4(c)-5.5(t)-0.7( as)-6.4(so)-6.4(ci)-7.2(ati)-7.2(o)-6.4(n)0.2( )10.9(w)-6.3(a)-1.5(s)-6.4( )10.9(i)-7.2(d)-5.2(enti)-7.2(fi)-7.2(ed)-5.2( betw)-6.3(een r)-8.3(e)1.4(fr)-8.3(ac)-5.5(tiv)-6.1(e s)-6.4(u)-2.2(rger)-8.3(y and)]TJ
0 -1.1196 TD
0.0014 Tc
-0.0014 Tw
[(aviati)8.4(o)-0.6(n)4.7( acc)10.1(ide)6.1(n)4.7(ts. M)11.2(o)-1.7(n)4.7(i)-2.5(to)9.1(rin)4.7(g )10.9(wi)8.4(ll be)6.1( )10.9(on)4.7(goin)4.7(g t)14.9(o)-1.7( e)6.1(n)4.7(sure)6.1( )]TJ
22.067 0 TD
[(th)5.5(at ai)8.4(rm)5.8(e)6.1(n)4.7( with)5.5( n)4.7(e)6.1(we)6.1(r )10.9(lase)6.1(r r)7.3(e)6.1(f)8.8(r)-3.6(acti)8.4(v)-0.6(e)6.1( pr)7.3(oce)6.1(du)13.4(re)6.1(s)]TJ
-22.067 -1.1196 TD
0.002 Tc
-0.002 Tw
[(pe)6.7(rf)9.4(orm)6.4( )10.9(safe)6.7(ly)5.2( in)5.3( t)4.7(h)6.1(e)6.7( av)10.1(iat)4.7(i)-1.9(on)5.3( e)6.7(n)5.3(v)10.1(i)-1.9(r)7.9(o)-1.1(n)5.3(m)6.4(e)6.7(n)5.3(t)4.7(.)]TJ
ET
81.68 418.3 0.72 -261.104 re
f
555.641 418.3 0.72 -261.104 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 149.8756 Tm
-0.0018 Tc
0.0007 Tw
[(17. )-17.2(Ke)-7(y W)-7.4(o)-19.3(r)6.1(d)-6.5(s)-29391.7(18. )-17.2(Di)-8.7(s)-10.4(t)-7.7(r)6.1(i)-8.7(b)-9.5(u)2.7(t)-7.7(i)-8.7(on St)-7.7(a)-8.5(t)-7.6(e)-7(m)5.1(e)-7(n)4.7(t)]TJ
ET
81.68 157.195 474.681 -0.72 re
f
81.68 156.475 0.72 -8.279 re
f
334.979 156.475 0.72 -8.279 re
f
555.641 156.475 0.72 -8.279 re
f
81.68 148.196 0.72 -11.519 re
f
335.099 148.196 0.48 -11.519 re
f
555.641 148.196 0.72 -11.519 re
f
81.68 136.677 0.72 -11.519 re
f
335.099 136.677 0.48 -11.519 re
f
555.641 136.677 0.72 -11.519 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 87.4391 138.9563 Tm
-0.0008 Tc
0.0008 Tw
[(Refracti)6.2(v)-2.5(e Surger)-5.8(y)2.4(,)10.1( Aviati)6.2(o)-2.5(n Vi)6.2(si)6.2(on, Acc)7.9(i)-4.7(dent)]TJ
17.4763 0 TD
[( Risk)-3511.3(Document i)6.2(s)-3.9( avai)6.2(lable to)-9( the pu)11.2(blic thr)-5.8(ou)11.2(gh the)]TJ
5.4694 -1.1196 TD
0.0012 Tc
-0.0121 Tw
[(National Te)5.9(ch)5.3(nical)9.1( )-10.9(Info)8.9(rm)5.6(ation Se)5.9(rv)9.3(ice)5.9(;)]TJ
T*
0.0009 Tc
-0.0009 Tw
[(Spr)6.8(ingf)8.3(ield, V)13.9(i)-3(rg)12.1(inia 22)11.8(161)]TJ
ET
81.68 125.277 0.72 -13.919 re
f
335.099 125.277 0.48 -13.919 re
f
555.641 125.277 0.72 -13.919 re
f
BT
/F4 1 Tf
6.9589 0 0 6.9591 87.4391 103.9185 Tm
-0.0015 Tc
0.0004 Tw
[(19. Se)-6.7(c)-9.7(u)-14.2(r)6.4(i)-8.4(t)-7.3(y)0( Cl)-8.4(a)-8.2(s)-10.1(s)-10.1(i)-8.4(f. \()5.4(o)-1.7(f t)-24.6(h)5(i)-8.4(s)-10.1( r)6.4(e)-6.7(p)-9.2(o)-1.7(r)6.4(t)-24.6(\))-3667.3(20. Se)-6.7(c)-9.7(u)-14.2(r)6.4(i)-8.4(t)-7.4(y)0( Cl)-8.4(a)-8.2(s)-10.1(s)-10.1(i)-8.4(f. \()5.4(o)-1.7(f t)-24.6(h)5(i)-8.4(s)-10.1( p)-9.2(a)-8.2(ge)-6.7(\))-9219.4(21. No)-19(. of)-15.1( Pa)-8.2(ge)-6.7(s)-6079.5(22. )-17.2(Pr)6.4(i)-8.4(c)-9.7(e)]TJ
ET
81.68 111.238 474.681 -0.72 re
f
81.68 110.518 0.72 -8.28 re
f
220.988 110.518 0.72 -8.28 re
f
397.254 110.518 0.72 -8.28 re
f
496.245 110.518 0.72 -8.28 re
f
555.641 110.518 0.72 -8.28 re
f
81.68 102.239 0.72 -12.359 re
f
220.988 102.239 0.72 -12.359 re
f
397.254 102.239 0.72 -12.359 re
f
496.245 102.239 0.72 -12.359 re
f
555.641 102.239 0.72 -12.359 re
f
BT
/F1 1 Tf
11.0391 0 0 11.0393 125.836 80.6399 Tm
0.003 Tc
0 Tw
[(Un)6.3(cla)15.7(ssi)10(fie)7.7(d)-9618.4(U)0(n)6.3(cla)15.7(ssi)10(fie)7.7(d)-9629.3(1)0(6)]TJ
ET
81.68 89.999 0.72 -13.079 re
f
81.68 77.64 139.308 -0.72 re
f
220.988 89.999 0.72 -13.079 re
f
221.708 77.64 175.545 -0.72 re
f
397.254 89.999 0.72 -13.079 re
f
397.974 77.64 98.272 -0.72 re
f
496.245 89.999 0.72 -13.079 re
f
496.965 77.64 58.675 -0.72 re
f
555.641 89.999 0.72 -13.079 re
f
BT
/F3 1 Tf
9.9592 0 0 9.9594 142.3945 67.8006 Tm
0.0006 Tc
-0.0015 Tw
[(Form DO)-4.5(T)-14.9( F 1700.)-10.6(7)]TJ
/F7 1 Tf
9.1446 0 TD
-0.0009 Tc
0 Tw
( )Tj
8.0393 0 0 8.0395 238.9865 67.8006 Tm
-0.0041 Tc
0.0097 Tw
[( \(8-72\))-7447.2(Reproduc)-11.6(t)-9.7(i)-6(on of)5.2( c)-11.6(o)14.6(m)-6.9(p)-0.3(l)-6(e)-0.3(t)-9.7(e)-0.3(d)14.6( page aut)-9.7(hori)-6(zed)]TJ
ET
EMC
Q
endstream
endobj
19 0 obj
<<
/ProcSet [/PDF /Text ]
/Font <<
/F1 4 0 R
/F3 20 0 R
/F4 21 0 R
/F5 22 0 R
/F6 23 0 R
/F7 24 0 R
>>
/ExtGState <<
/GS2 8 0 R
/GS3 25 0 R
>>
/Properties <<
/MC1 16 0 R
>>
>>
endobj
26 0 obj
<<
/FunctionType 0
/Domain [0 1]
/Range [-1 1]
/BitsPerSample 16
/Size [256]
/Length 527
/Filter /FlateDecode
>>
stream
H
!"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~ ?
endstream
endobj
28 0 obj
<<
/Length 0
>>
stream
endstream
endobj
29 0 obj
<<
/ProcSet [/PDF ]
>>
endobj
31 0 obj
<<
/Length 8787
>>
stream
BT
/F1 1 Tf
10 0 0 10 313.68 36 Tm
0 0 0 1 k
/GS4 gs
0 Tc
0 Tw
(1)Tj
ET
0 0 0 1 K
0 J 0 j 0.48 w 10 M []0 d
/GS5 gs
1 i
69.96 737.76 m
555.96 737.76 l
S
BT
/F2 1 Tf
16 0 0 16 190.32 714 Tm
/GS4 gs
(T)Tj
11.2 0 0 11.2 200.64 714 Tm
0.0046 Tc
(HE)Tj
16 0 0 16 216.24 714 Tm
-0.0065 Tc
( A)Tj
11.2 0 0 11.2 230.4 714 Tm
0.0001 Tc
[(VIA)75.1(TION)]TJ
16 0 0 16 276.6 714 Tm
0.001 Tc
( A)Tj
11.2 0 0 11.2 290.64 714 Tm
-0.0007 Tc
[(C)13.3(CIDENT)]TJ
16 0 0 16 341.28 714 Tm
-0.0055 Tc
( E)Tj
11.2 0 0 11.2 354.84 714 Tm
-0.0001 Tc
[(XP)10.6(ERIENCE)]TJ
16 0 0 16 416.52 714 Tm
0 Tc
( )Tj
11.2 0 0 11.2 420.72 714 Tm
0.0033 Tc
(OF)Tj
16 0 0 16 176.04 696 Tm
0 Tc
(C)Tj
11.2 0 0 11.2 187.08 696 Tm
0.001 Tc
(IVILIAN)Tj
16 0 0 16 228.72 696 Tm
( A)Tj
11.2 0 0 11.2 242.88 696 Tm
0.0013 Tc
(IRMEN)Tj
16 0 0 16 279.72 696 Tm
-0.0275 Tc
( W)Tj
11.2 0 0 11.2 298.8 696 Tm
-0.0003 Tc
(ITH)Tj
16 0 0 16 319.2 696 Tm
0.006 Tc
( R)Tj
11.2 0 0 11.2 333.96 696 Tm
-0.0002 Tc
[(EFRA)21.2(CTIVE)]TJ
16 0 0 16 393.84 696 Tm
0.0065 Tc
( S)Tj
11.2 0 0 11.2 406.2 696 Tm
0.0004 Tc
[(UR)21.8(GER)43.3(Y)]TJ
/F8 1 Tf
12 0 0 12 139.2 650.4 Tm
0.0178 Tc
(INTRODUCTION)Tj
/F1 1 Tf
11 0 0 11 84 624.36 Tm
0.0236 Tc
-0.1199 Tw
(Optimum vision is essential for pilots to ensure safe)Tj
-1.0909 -1.1782 TD
0.0233 Tc
-0.0125 Tw
(flight operations. The pilot must see well at distance)Tj
0 -1.1891 TD
0.0235 Tc
0.2261 Tw
(to detect and identify airborne traffic, as well as)Tj
0 -1.1782 TD
0.0232 Tc
-0.0136 Tw
(hazards that may be on runways and taxiways. Good)Tj
T*
0.0236 Tc
0.1363 Tw
(intermediate and near vision is also essential since)Tj
0 -1.1891 TD
0.1227 Tw
(cockpit instruments and aviation materials such as)Tj
0 -1.1782 TD
0.0232 Tc
0.1688 Tw
(flight manifests, charts, and maps must be clearly)Tj
T*
0.0058 Tw
(visible to properly execute flight procedures in vary-)Tj
0 -1.1891 TD
0.0239 Tc
0.0046 Tw
(ing ambient light conditions.)Tj
1.0909 -1.1782 TD
0.0235 Tc
0.0506 Tw
(Refractive error is an optical defect that prevents)Tj
-1.0909 -1.1782 TD
0.0232 Tc
0.0463 Tw
(light rays entering the eye to be focused as a single,)Tj
0 -1.1891 TD
-0.0386 Tw
(clear image on the retina. Blurred vision from refrac-)Tj
0 -1.1782 TD
0.0235 Tc
0.0712 Tw
(tive error can interfere with a pilots ability to effi-)Tj
T*
0.0217 Tc
-0.125 Tw
(ciently perform operational tasks and can compromise)Tj
0 -1.1891 TD
0.0235 Tc
0.1136 Tw
(aviation safety. Common refractive conditions \(see)Tj
0 -1.1782 TD
0.0231 Tc
-0.1065 Tw
(Figure 1\) that are correctable with ophthalmic devices)Tj
T*
0.2499 Tw
(\(eyeglasses, contact lenses\) include myopia \(near-)Tj
0 -1.1891 TD
0.1568 Tw
(sightedness\), hyperopia \(farsightedness\), and astig-)Tj
0 -1.1782 TD
-0.0102 Tw
(matism \(irregular corneal curvature\). Approximately)Tj
T*
0.0233 Tc
-0.0125 Tw
(55% of the U.S. population rely on corrective lenses)Tj
0 -1.1891 TD
0.1443 Tw
(to achieve a quality of vision satisfactory for their)Tj
0 -1.1782 TD
0.0225 Tc
0.0045 Tw
(daily needs \(1\).)Tj
1.0909 -1.1782 TD
0.0233 Tc
0.1691 Tw
(Civil airmen with refractive surgical procedures)Tj
-1.0909 -1.1891 TD
-0.0799 Tw
(have been allowed to obtain Federal Aviation Admin-)Tj
0 -1.1782 TD
0.1598 Tw
(istration \(FAA\) medical certificates since the early)Tj
T*
-0.0512 Tw
(1980s. The majority of these airmen had a procedure)Tj
0 -1.1891 TD
0.0143 Tw
(known as radial keratotomy \(RK\) performed to cor-)Tj
0 -1.1782 TD
-0.0131 Tw
(rect their defective distant vision. In 1995, the Food)Tj
T*
0.0235 Tc
-0.0559 Tw
(and Drug Administration \(FDA\) approved the use of)Tj
0 -1.1891 TD
0.023 Tc
0.113 Tw
(the excimer laser to perform refractive surgery \(2\).)Tj
0 -1.1782 TD
0.0232 Tc
0.2146 Tw
(Laser procedures, such as photorefractive keratec-)Tj
T*
0.0106 Tw
(tomy \(PRK\) and laser-assisted in situ keratomileusis)Tj
0 -1.1891 TD
0.0409 Tw
(\(LASIK\), are being performed on a rapidly growing)Tj
0 -1.1782 TD
0.0234 Tc
-0.0325 Tw
(number of people, including civilian pilots \(3\). Pres-)Tj
T*
0.0727 Tw
(ently, applicants with refractive surgical procedures)Tj
0 -1.1891 TD
0.0236 Tc
0.061 Tw
(may obtain an airman medical certificate without a)Tj
0 -1.1782 TD
0.0233 Tc
-0.0531 Tw
(waiver if they meet the visual acuity standards for the)Tj
T*
0.1299 Tw
(class of medical certificate applied, and an eyecare)Tj
0 -1.1891 TD
-0.0233 Tw
(specialist verifies that their vision is stable, healing is)Tj
0 -1.1782 TD
-0.0059 Tw
(complete, and no glare intolerance is present \(4\).)Tj
1.0909 -1.1782 TD
0.0035 Tc
-0.025 Tw
(RK, PRK, and LASIK procedures are similar only in)Tj
-1.0909 -1.1891 TD
0.0033 Tc
-0.0101 Tw
(that the goal is to improve uncorrected visual acuity by)Tj
0 -1.1782 TD
0.1305 Tw
(permanently altering the curvature of the eyes outer)Tj
T*
0.0032 Tc
-0.0759 Tw
[(surface or cornea. RK requires a surgeon to make a series)]TJ
0 -1.1891 TD
0.0034 Tc
0.2383 Tw
(of spoke-like incisions around the periphery of the)Tj
22.9091 52.0036 TD
0.0033 Tc
-0.0784 Tw
(cornea that, once healed, flattens the cornea and reduces)Tj
0 -1.1782 TD
0.161 Tw
(myopia. PRK reshapes the cornea through a process)Tj
0 -1.1891 TD
0.0032 Tc
-0.0396 Tw
(called photoablation, which utilizes the excimer laser to)Tj
0 -1.1782 TD
0.0034 Tc
-0.0858 Tw
(vaporize the corneas outer tissue. LASIK uses a specially)Tj
T*
0.0032 Tc
-0.0539 Tw
(designed surgical scalpel \(microkeratome\) to slice a thin)Tj
0 -1.1891 TD
0.0034 Tc
0.1379 Tw
(horizontal flap from the top of the cornea leaving it)Tj
0 -1.1782 TD
0.0031 Tc
-0.0013 Tw
(connected by a small hinge of tissue. The flap is folded)Tj
T*
-0.0863 Tw
(aside, and the excimer laser is used to remove tissue from)Tj
0 -1.1891 TD
-0.0318 Tw
(the corneal stroma. The corneal flap is then returned to)Tj
0 -1.1782 TD
0.0036 Tc
0.0018 Tw
(its original position \(see Figure 2\).)Tj
1.0909 -1.1782 TD
0.0232 Tc
-0.0354 Tw
(Approximately 1.3 million laser refractive surgical)Tj
-1.0909 -1.1891 TD
0.0234 Tc
-0.1153 Tw
(procedures were performed in the United States in the)Tj
0 -1.1782 TD
0.0231 Tc
-0.0888 Tw
(year 2000 \(5\) and a 35 to 40% growth rate is expected)Tj
T*
0.0346 Tw
(over the next five years \(6\). Success rates of 90% or)Tj
0 -1.1891 TD
0.0233 Tc
0.0844 Tw
(better have been reported for patients with low-to-)Tj
0 -1.1782 TD
0.023 Tc
-0.0961 Tw
(moderate myopia who have had laser refractive proce-)Tj
T*
-0.1159 Tw
(dures \(7,8,9\). However, the criteria for success used in)Tj
0 -1.1891 TD
0.0232 Tc
-0.1247 Tw
(many of these studies permit uncorrected visual acuity)Tj
0 -1.1782 TD
0.023 Tc
0.0004 Tw
(\(VA\) as low as 20/40 \(10\). While a VA in this range)Tj
T*
0.0233 Tc
0.0669 Tw
[(may be adequate for the general population, pilots,)]TJ
0 -1.1891 TD
0.1466 Tw
(who must safely perform a wide variety of vision-)Tj
0 -1.1782 TD
0.1418 Tw
(related flight operations under visually demanding)Tj
T*
0.0235 Tc
-0.0523 Tw
(environmental conditions, may find these results un-)Tj
0 -1.1891 TD
-0.0046 Tw
(acceptable \(11\). Aviation concerns remain regarding)Tj
0 -1.1782 TD
0.0233 Tc
-0.1034 Tw
(the quality of the resulting vision correction \(12\), side)Tj
T*
0.0235 Tc
0.0546 Tw
(effects in the aviation environment \(13,14,15\), and)Tj
0 -1.1891 TD
0.0233 Tc
0.0028 Tw
(the potential for surgical complications \(16,17\).)Tj
1.0909 -1.1782 TD
0.0235 Tc
0.0485 Tw
(The aircraft accident experience of civilian pilots)Tj
-1.0909 -1.1782 TD
0.0233 Tc
-0.1078 Tw
(with refractive surgical procedures has not been previ-)Tj
0 -1.1891 TD
0.1838 Tw
(ously examined or reported. Studies by Dille and)Tj
0 -1.1782 TD
-0.0111 Tw
(Booze, conducted from 1976 to 1981, examined the)Tj
T*
0.0237 Tc
0.2191 Tw
(relationship between aviation accidents and static)Tj
0 -1.1891 TD
0.0233 Tc
0.1409 Tw
(visual conditions \(18,19,20\). Two of these studies)Tj
0 -1.1782 TD
0.0237 Tc
0.2136 Tw
(found statistically significant associations between)Tj
T*
0.0148 Tc
-0.125 Tw
(certain visual conditions and aircraft accidents \(19,20\).)Tj
0 -1.1891 TD
0.0233 Tc
0.1084 Tw
(At that time, refractive surgery was not commonly)Tj
0 -1.1782 TD
0.0235 Tc
0.0697 Tw
(used by aviators and was not one of the conditions)Tj
T*
0.0233 Tc
0.2013 Tw
[(studied. The recent growth in popularity of laser)]TJ
0 -1.1891 TD
0.0331 Tw
(refractive surgery prompted a review of the aviation)Tj
0 -1.1782 TD
-0.0364 Tw
(accident experience of airmen with refractive surgery)Tj
T*
0.0231 Tc
-0.0197 Tw
(\(3\). A retrospective, cross-sectional cohort study was)Tj
0 -1.1891 TD
0.0233 Tc
0.1811 Tw
(performed to determine whether accident rates of)Tj
0 -1.1782 TD
0.0773 Tw
(airmen with refractive surgery differed significantly)Tj
T*
0.0742 Tw
(from those of airmen without refractive procedures)Tj
0 -1.1891 TD
-0.0023 Tw
(during the study period \(1994-96\).)Tj
ET
endstream
endobj
32 0 obj
<<
/ProcSet [/PDF /Text ]
/Font <<
/F1 4 0 R
/F2 5 0 R
/F8 33 0 R
>>
/ExtGState <<
/GS4 34 0 R
/GS5 35 0 R
>>
>>
endobj
36 0 obj
<<
/FunctionType 0
/Domain [0 1]
/Range [-1 1]
/BitsPerSample 16
/Size [256]
/Length 527
/Filter /FlateDecode
>>
stream
H
!"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~ ?
endstream
endobj
37 0 obj
<<
/Length 775
>>
stream
Microsoft PowerPoint - FIGURE-1
endstream
endobj
40 0 obj
<<
/Length 28685
>>
stream
BT
/F1 1 Tf
10 0 0 10 295.44 36.96 Tm
0 0 0 1 k
/GS4 gs
0 Tc
0 Tw
(2)Tj
ET
/EmbeddedDocument /MC2 BDC
q
1 i
92.04 738 411 -623.04 re
W n
q
/RelativeColorimetric ri
1 1 1 rg
/GS6 gs
33.96 784.484 540 -720.046 re
f
Q
Q
q
/RelativeColorimetric ri
BT
/F3 1 Tf
20.04 0 0 20.0413 180.7197 530.9076 Tm
0 0 0 rg
/GS6 gs
-0.0007 Tc
-0.0019 Tw
[(Myopia \(near)5.1(sightedness\))]TJ
14.04 0 0 14.0409 191.7597 558.1494 Tm
-0.0054 Tc
0 Tw
(Lens)Tj
-2.0256 9.3162 TD
-0.0061 Tc
[(Cor)-10.3(nea)]TJ
-3.1538 -7.8889 TD
-0.0053 Tc
0.0094 Tw
(Light Rays)Tj
ET
0 0 0 RG
0 J 1 j 0.96 w 10 M []0 d
1 i
144.6 591.992 m
169.56 630.274 l
S
172.92 627.754 m
173.88 637.115 l
165.84 632.314 l
f*
145.08 592.952 m
176.76 617.193 l
S
179.16 613.593 m
183.24 622.114 l
174 620.313 l
f*
185.04 687.278 m
218.64 648.635 l
S
215.16 645.995 m
223.92 642.515 l
221.64 651.635 l
f*
BT
14.04 0 0 14.0409 387.8397 577.8306 Tm
-0.0036 Tc
0 Tw
(Fovea)Tj
ET
0.801 0.801 1 rg
0.5 0.5 0.5 RG
1 J 2.28 w
315.24 631.114 m
315.24 651.755 294.12 668.437 268.08 668.437 c
241.92 668.437 220.92 651.755 220.92 631.114 c
220.92 610.473 241.92 593.672 268.08 593.672 c
294.12 593.672 315.24 610.473 315.24 631.114 c
b*
370.68 631.114 m
370.68 664.956 340.32 692.438 302.88 692.438 c
265.44 692.438 235.2 664.956 235.2 631.114 c
235.2 597.272 265.44 569.67 302.88 569.67 c
340.32 569.67 370.68 597.272 370.68 631.114 c
b*
312.12 630.874 m
312.12 650.435 292.2 666.396 267.6 666.396 c
243 666.396 223.08 650.435 223.08 630.874 c
223.08 611.313 243 595.352 267.6 595.352 c
292.2 595.352 312.12 611.313 312.12 630.874 c
f*
q
240.48 655.676 12.8 -24.002 re
W n
240.48 655.716 12.6 -23.642 re
W n
246.96 655.716 m
246.24 654.396 l
245.76 653.676 l
245.52 652.956 l
245.16 652.236 l
244.8 651.396 l
244.56 650.675 l
244.2 649.955 l
243.96 649.235 l
243.24 647.795 l
243 647.075 l
242.88 646.235 l
242.64 645.515 l
242.4 644.675 l
242.16 643.955 l
241.92 643.115 l
241.68 642.395 l
241.56 641.435 l
241.44 640.715 l
241.2 639.995 l
241.08 639.035 l
240.96 638.315 l
240.84 637.475 l
240.84 636.634 l
240.6 634.954 l
240.6 634.114 l
240.48 633.394 l
240.48 628.234 l
240.6 627.274 l
240.6 626.554 l
240.72 625.594 l
240.84 624.874 l
240.84 624.034 l
240.96 623.074 l
241.08 622.474 l
241.2 621.514 l
241.44 620.674 l
241.68 619.233 l
241.92 618.273 l
242.4 616.833 l
242.64 615.993 l
242.88 615.273 l
243 614.433 l
243.24 613.713 l
243.6 612.873 l
243.96 612.273 l
244.2 611.433 l
244.56 610.713 l
244.8 609.993 l
245.16 609.153 l
245.52 608.553 l
245.76 607.833 l
246.24 607.113 l
246.96 605.673 l
247.56 607.113 l
248.04 607.713 l
248.28 608.553 l
248.64 609.153 l
248.88 609.873 l
249.24 610.593 l
249.72 612.033 l
250.08 612.753 l
250.56 614.193 l
251.04 615.873 l
251.16 616.593 l
251.64 618.033 l
251.88 619.713 l
252.12 620.433 l
252.36 621.274 l
252.72 623.794 l
252.72 624.634 l
252.84 625.354 l
252.96 626.314 l
252.96 627.994 l
253.08 628.714 l
253.08 632.194 l
252.96 633.034 l
252.96 634.714 l
252.72 636.394 l
252.72 637.235 l
252.48 638.915 l
252.36 639.635 l
251.88 641.315 l
251.76 642.155 l
251.64 642.875 l
251.4 643.715 l
251.16 644.435 l
251.04 645.275 l
250.8 646.115 l
250.08 648.275 l
249.72 649.115 l
249.48 649.835 l
249.24 650.675 l
248.88 651.396 l
248.64 652.115 l
248.28 652.956 l
248.04 653.556 l
247.56 654.276 l
247.32 654.996 l
246.96 655.716 l
W n
q
12.6 0 0 -23.6415 240.48 655.7158 cm
/Im2 Do
Q
Q
q
246.96 655.716 m
246.24 654.396 l
245.76 653.676 l
245.52 652.956 l
245.16 652.236 l
244.8 651.396 l
244.56 650.675 l
244.2 649.955 l
243.96 649.235 l
243.24 647.795 l
243 647.075 l
242.88 646.235 l
242.64 645.515 l
242.4 644.675 l
242.16 643.955 l
241.92 643.115 l
241.68 642.395 l
241.56 641.435 l
241.44 640.715 l
241.2 639.995 l
241.08 639.035 l
240.96 638.315 l
240.84 637.475 l
240.84 636.634 l
240.6 634.954 l
240.6 634.114 l
240.48 633.394 l
240.48 628.234 l
240.6 627.274 l
240.6 626.554 l
240.72 625.594 l
240.84 624.874 l
240.84 624.034 l
240.96 623.074 l
241.08 622.474 l
241.2 621.514 l
241.44 620.674 l
241.68 619.233 l
241.92 618.273 l
242.4 616.833 l
242.64 615.993 l
242.88 615.273 l
243 614.433 l
243.24 613.713 l
243.6 612.873 l
243.96 612.273 l
244.2 611.433 l
244.56 610.713 l
244.8 609.993 l
245.16 609.153 l
245.52 608.553 l
245.76 607.833 l
246.24 607.113 l
246.96 605.673 l
247.56 607.113 l
248.04 607.713 l
248.28 608.553 l
248.64 609.153 l
248.88 609.873 l
249.24 610.593 l
249.72 612.033 l
250.08 612.753 l
250.56 614.193 l
251.04 615.873 l
251.16 616.593 l
251.64 618.033 l
251.88 619.713 l
252.12 620.433 l
252.36 621.274 l
252.72 623.794 l
252.72 624.634 l
252.84 625.354 l
252.96 626.314 l
252.96 627.994 l
253.08 628.714 l
253.08 632.194 l
252.96 633.034 l
252.96 634.714 l
252.72 636.394 l
252.72 637.235 l
252.48 638.915 l
252.36 639.635 l
251.88 641.315 l
251.76 642.155 l
251.64 642.875 l
251.4 643.715 l
251.16 644.435 l
251.04 645.275 l
250.8 646.115 l
250.08 648.275 l
249.72 649.115 l
249.48 649.835 l
249.24 650.675 l
248.88 651.396 l
248.64 652.115 l
248.28 652.956 l
248.04 653.556 l
247.56 654.276 l
247.32 654.996 l
246.96 655.716 l
W* n
0.996 0.996 0.996 rg
240.48 632.074 12.6 -2.88 re
f
Q
q
240.48 628.874 12.8 -23.601 re
W n
240.48 629.194 12.6 -23.522 re
W n
246.96 655.716 m
246.24 654.396 l
245.76 653.676 l
245.52 652.956 l
245.16 652.236 l
244.8 651.396 l
244.56 650.675 l
244.2 649.955 l
243.96 649.235 l
243.24 647.795 l
243 647.075 l
242.88 646.235 l
242.64 645.515 l
242.4 644.675 l
242.16 643.955 l
241.92 643.115 l
241.68 642.395 l
241.56 641.435 l
241.44 640.715 l
241.2 639.995 l
241.08 639.035 l
240.96 638.315 l
240.84 637.475 l
240.84 636.634 l
240.6 634.954 l
240.6 634.114 l
240.48 633.394 l
240.48 628.234 l
240.6 627.274 l
240.6 626.554 l
240.72 625.594 l
240.84 624.874 l
240.84 624.034 l
240.96 623.074 l
241.08 622.474 l
241.2 621.514 l
241.44 620.674 l
241.68 619.233 l
241.92 618.273 l
242.4 616.833 l
242.64 615.993 l
242.88 615.273 l
243 614.433 l
243.24 613.713 l
243.6 612.873 l
243.96 612.273 l
244.2 611.433 l
244.56 610.713 l
244.8 609.993 l
245.16 609.153 l
245.52 608.553 l
245.76 607.833 l
246.24 607.113 l
246.96 605.673 l
247.56 607.113 l
248.04 607.713 l
248.28 608.553 l
248.64 609.153 l
248.88 609.873 l
249.24 610.593 l
249.72 612.033 l
250.08 612.753 l
250.56 614.193 l
251.04 615.873 l
251.16 616.593 l
251.64 618.033 l
251.88 619.713 l
252.12 620.433 l
252.36 621.274 l
252.72 623.794 l
252.72 624.634 l
252.84 625.354 l
252.96 626.314 l
252.96 627.994 l
253.08 628.714 l
253.08 632.194 l
252.96 633.034 l
252.96 634.714 l
252.72 636.394 l
252.72 637.235 l
252.48 638.915 l
252.36 639.635 l
251.88 641.315 l
251.76 642.155 l
251.64 642.875 l
251.4 643.715 l
251.16 644.435 l
251.04 645.275 l
250.8 646.115 l
250.08 648.275 l
249.72 649.115 l
249.48 649.835 l
249.24 650.675 l
248.88 651.396 l
248.64 652.115 l
248.28 652.956 l
248.04 653.556 l
247.56 654.276 l
247.32 654.996 l
246.96 655.716 l
W n
q
12.6 0 0 -23.5215 240.48 629.194 cm
/Im3 Do
Q
Q
0 0 0 RG
0.96 w
246.96 655.716 m
246.24 654.396 l
245.76 653.676 l
245.52 652.956 l
245.16 652.236 l
244.8 651.396 l
244.56 650.675 l
244.2 649.955 l
243.96 649.235 l
243.24 647.795 l
243 647.075 l
242.88 646.235 l
242.64 645.515 l
242.4 644.675 l
242.16 643.955 l
241.92 643.115 l
241.68 642.395 l
241.56 641.435 l
241.44 640.715 l
241.2 639.995 l
241.08 639.035 l
240.96 638.315 l
240.84 637.475 l
240.84 636.634 l
240.6 634.954 l
240.6 634.114 l
240.48 633.394 l
240.48 628.234 l
240.6 627.274 l
240.6 626.554 l
240.72 625.594 l
240.84 624.874 l
240.84 624.034 l
240.96 623.074 l
241.08 622.474 l
241.2 621.514 l
241.44 620.674 l
241.68 619.233 l
241.92 618.273 l
242.4 616.833 l
242.64 615.993 l
242.88 615.273 l
243 614.433 l
243.24 613.713 l
243.6 612.873 l
243.96 612.273 l
244.2 611.433 l
244.56 610.713 l
244.8 609.993 l
245.16 609.153 l
245.52 608.553 l
245.76 607.833 l
246.24 607.113 l
246.96 605.673 l
247.56 607.113 l
248.04 607.713 l
248.28 608.553 l
248.64 609.153 l
248.88 609.873 l
249.24 610.593 l
249.72 612.033 l
250.08 612.753 l
250.56 614.193 l
251.04 615.873 l
251.16 616.593 l
251.64 618.033 l
251.88 619.713 l
252.12 620.433 l
252.36 621.274 l
252.72 623.794 l
252.72 624.634 l
252.84 625.354 l
252.96 626.314 l
252.96 627.994 l
253.08 628.714 l
253.08 632.194 l
252.96 633.034 l
252.96 634.714 l
252.72 636.394 l
252.72 637.235 l
252.48 638.915 l
252.36 639.635 l
251.88 641.315 l
251.76 642.155 l
251.64 642.875 l
251.4 643.715 l
251.16 644.435 l
251.04 645.275 l
250.8 646.115 l
250.08 648.275 l
249.72 649.115 l
249.48 649.835 l
249.24 650.675 l
248.88 651.396 l
248.64 652.115 l
248.28 652.956 l
248.04 653.556 l
247.56 654.276 l
247.32 654.996 l
246.96 655.716 l
138.96 624.154 m
228.72 624.154 l
353.28 631.954 l
138.24 639.275 m
231.36 639.275 l
231.12 639.395 l
353.52 631.954 l
S
0 J
209.76 570.87 m
239.28 614.553 l
S
0 0 0 rg
242.64 611.913 m
243.72 621.274 l
235.56 616.593 l
f*
BT
14.04 0 0 14.0409 359.0396 682.2373 Tm
-0.002 Tc
-0.0025 Tw
[(Point of)6.2( )-8.6(F)10.7(o)2.2(cus)]TJ
ET
408.24 677.557 m
358.56 637.235 l
S
356.16 640.835 m
352.32 632.194 l
361.44 634.234 l
f*
401.4 591.632 m
372.84 627.394 l
S
376.44 629.914 m
367.8 633.754 l
369.72 624.514 l
f*
BT
20.04 0 0 20.0413 174.4797 359.1766 Tm
-0.0004 Tc
-0.0081 Tw
[(Hyperopia \(far)5.4(sightedness\))]TJ
ET
0.801 0.801 1 rg
0.5 0.5 0.5 RG
1 J 2.28 w
308.88 446.902 m
308.88 467.544 288.48 484.225 263.28 484.225 c
238.08 484.225 217.8 467.544 217.8 446.902 c
217.8 426.261 238.08 409.46 263.28 409.46 c
288.48 409.46 308.88 426.261 308.88 446.902 c
b*
362.28 446.902 m
362.28 480.744 333 508.226 296.88 508.226 c
260.76 508.226 231.6 480.744 231.6 446.902 c
231.6 413.06 260.76 385.458 296.88 385.458 c
333 385.458 362.28 413.06 362.28 446.902 c
b*
305.76 446.542 m
305.76 466.104 286.56 482.065 262.8 482.065 c
239.04 482.065 219.84 466.104 219.84 446.542 c
219.84 426.981 239.04 411.02 262.8 411.02 c
286.56 411.02 305.76 426.981 305.76 446.542 c
f*
q
236.76 471.342 12.13 -23.871 re
W n
236.76 471.504 12.12 -23.642 re
W n
243 471.504 m
242.28 470.064 l
241.8 469.464 l
241.56 468.624 l
241.2 468.024 l
240.84 467.184 l
240.6 466.464 l
240.24 465.744 l
240 464.904 l
239.76 464.303 l
239.4 463.463 l
239.16 462.863 l
239.04 462.023 l
238.8 461.183 l
238.56 460.463 l
238.32 459.623 l
238.08 458.903 l
237.72 456.383 l
237.48 455.783 l
237.36 454.823 l
237.24 453.983 l
237.12 453.263 l
237.12 452.303 l
237 451.583 l
236.88 450.623 l
236.88 449.903 l
236.76 449.062 l
236.76 443.902 l
236.88 443.062 l
236.88 442.222 l
237.12 440.542 l
237.12 439.822 l
237.24 438.862 l
237.36 438.142 l
237.48 437.302 l
237.72 436.342 l
237.84 435.742 l
238.08 434.061 l
238.32 433.221 l
238.56 432.621 l
238.8 431.781 l
239.04 431.061 l
239.16 430.221 l
239.4 429.381 l
239.76 428.661 l
240.24 427.221 l
240.6 426.381 l
240.84 425.661 l
241.56 424.221 l
241.8 423.621 l
242.28 422.901 l
243 421.461 l
243.6 422.781 l
243.96 423.501 l
244.2 424.221 l
244.56 424.941 l
244.8 425.661 l
245.16 426.261 l
245.4 427.101 l
245.64 427.701 l
245.88 428.541 l
246.36 429.981 l
246.6 430.821 l
246.84 431.541 l
246.96 432.381 l
247.2 432.981 l
247.44 433.822 l
247.56 434.542 l
247.68 435.502 l
247.8 436.222 l
248.16 437.062 l
248.28 437.902 l
248.4 438.622 l
248.52 439.582 l
248.52 440.302 l
248.76 441.982 l
248.76 443.662 l
248.88 444.502 l
248.88 447.982 l
248.76 448.702 l
248.76 450.503 l
248.52 452.183 l
248.52 452.903 l
248.4 453.863 l
248.28 454.583 l
248.16 455.423 l
247.8 456.143 l
247.68 457.103 l
247.56 457.823 l
247.44 458.663 l
247.2 459.383 l
246.96 460.223 l
246.84 461.063 l
246.6 461.783 l
246.36 462.623 l
246.12 463.223 l
245.88 464.063 l
245.64 464.783 l
245.16 466.464 l
244.8 467.064 l
244.56 467.904 l
244.2 468.624 l
243.96 469.344 l
243.6 469.944 l
243.36 470.784 l
243 471.504 l
W n
q
12.12 0 0 -23.6415 236.76 471.5039 cm
/Im4 Do
Q
Q
q
243 471.504 m
242.28 470.064 l
241.8 469.464 l
241.56 468.624 l
241.2 468.024 l
240.84 467.184 l
240.6 466.464 l
240.24 465.744 l
240 464.904 l
239.76 464.303 l
239.4 463.463 l
239.16 462.863 l
239.04 462.023 l
238.8 461.183 l
238.56 460.463 l
238.32 459.623 l
238.08 458.903 l
237.72 456.383 l
237.48 455.783 l
237.36 454.823 l
237.24 453.983 l
237.12 453.263 l
237.12 452.303 l
237 451.583 l
236.88 450.623 l
236.88 449.903 l
236.76 449.062 l
236.76 443.902 l
236.88 443.062 l
236.88 442.222 l
237.12 440.542 l
237.12 439.822 l
237.24 438.862 l
237.36 438.142 l
237.48 437.302 l
237.72 436.342 l
237.84 435.742 l
238.08 434.061 l
238.32 433.221 l
238.56 432.621 l
238.8 431.781 l
239.04 431.061 l
239.16 430.221 l
239.4 429.381 l
239.76 428.661 l
240.24 427.221 l
240.6 426.381 l
240.84 425.661 l
241.56 424.221 l
241.8 423.621 l
242.28 422.901 l
243 421.461 l
243.6 422.781 l
243.96 423.501 l
244.2 424.221 l
244.56 424.941 l
244.8 425.661 l
245.16 426.261 l
245.4 427.101 l
245.64 427.701 l
245.88 428.541 l
246.36 429.981 l
246.6 430.821 l
246.84 431.541 l
246.96 432.381 l
247.2 432.981 l
247.44 433.822 l
247.56 434.542 l
247.68 435.502 l
247.8 436.222 l
248.16 437.062 l
248.28 437.902 l
248.4 438.622 l
248.52 439.582 l
248.52 440.302 l
248.76 441.982 l
248.76 443.662 l
248.88 444.502 l
248.88 447.982 l
248.76 448.702 l
248.76 450.503 l
248.52 452.183 l
248.52 452.903 l
248.4 453.863 l
248.28 454.583 l
248.16 455.423 l
247.8 456.143 l
247.68 457.103 l
247.56 457.823 l
247.44 458.663 l
247.2 459.383 l
246.96 460.223 l
246.84 461.063 l
246.6 461.783 l
246.36 462.623 l
246.12 463.223 l
245.88 464.063 l
245.64 464.783 l
245.16 466.464 l
244.8 467.064 l
244.56 467.904 l
244.2 468.624 l
243.96 469.344 l
243.6 469.944 l
243.36 470.784 l
243 471.504 l
W* n
0.996 0.996 0.996 rg
236.76 447.862 12.12 -2.88 re
f
Q
q
236.76 444.764 12.273 -11.456 re
W n
236.76 444.982 12.12 -11.401 re
W n
243 471.504 m
242.28 470.064 l
241.8 469.464 l
241.56 468.624 l
241.2 468.024 l
240.84 467.184 l
240.6 466.464 l
240.24 465.744 l
240 464.904 l
239.76 464.303 l
239.4 463.463 l
239.16 462.863 l
239.04 462.023 l
238.8 461.183 l
238.56 460.463 l
238.32 459.623 l
238.08 458.903 l
237.72 456.383 l
237.48 455.783 l
237.36 454.823 l
237.24 453.983 l
237.12 453.263 l
237.12 452.303 l
237 451.583 l
236.88 450.623 l
236.88 449.903 l
236.76 449.062 l
236.76 443.902 l
236.88 443.062 l
236.88 442.222 l
237.12 440.542 l
237.12 439.822 l
237.24 438.862 l
237.36 438.142 l
237.48 437.302 l
237.72 436.342 l
237.84 435.742 l
238.08 434.061 l
238.32 433.221 l
238.56 432.621 l
238.8 431.781 l
239.04 431.061 l
239.16 430.221 l
239.4 429.381 l
239.76 428.661 l
240.24 427.221 l
240.6 426.381 l
240.84 425.661 l
241.56 424.221 l
241.8 423.621 l
242.28 422.901 l
243 421.461 l
243.6 422.781 l
243.96 423.501 l
244.2 424.221 l
244.56 424.941 l
244.8 425.661 l
245.16 426.261 l
245.4 427.101 l
245.64 427.701 l
245.88 428.541 l
246.36 429.981 l
246.6 430.821 l
246.84 431.541 l
246.96 432.381 l
247.2 432.981 l
247.44 433.822 l
247.56 434.542 l
247.68 435.502 l
247.8 436.222 l
248.16 437.062 l
248.28 437.902 l
248.4 438.622 l
248.52 439.582 l
248.52 440.302 l
248.76 441.982 l
248.76 443.662 l
248.88 444.502 l
248.88 447.982 l
248.76 448.702 l
248.76 450.503 l
248.52 452.183 l
248.52 452.903 l
248.4 453.863 l
248.28 454.583 l
248.16 455.423 l
247.8 456.143 l
247.68 457.103 l
247.56 457.823 l
247.44 458.663 l
247.2 459.383 l
246.96 460.223 l
246.84 461.063 l
246.6 461.783 l
246.36 462.623 l
246.12 463.223 l
245.88 464.063 l
245.64 464.783 l
245.16 466.464 l
244.8 467.064 l
244.56 467.904 l
244.2 468.624 l
243.96 469.344 l
243.6 469.944 l
243.36 470.784 l
243 471.504 l
W n
q
12.12 0 0 -11.4007 236.76 444.9822 cm
/Im5 Do
Q
Q
q
236.76 433.555 12.375 -12.376 re
W n
236.76 433.581 12.12 -12.121 re
W n
243 471.504 m
242.28 470.064 l
241.8 469.464 l
241.56 468.624 l
241.2 468.024 l
240.84 467.184 l
240.6 466.464 l
240.24 465.744 l
240 464.904 l
239.76 464.303 l
239.4 463.463 l
239.16 462.863 l
239.04 462.023 l
238.8 461.183 l
238.56 460.463 l
238.32 459.623 l
238.08 458.903 l
237.72 456.383 l
237.48 455.783 l
237.36 454.823 l
237.24 453.983 l
237.12 453.263 l
237.12 452.303 l
237 451.583 l
236.88 450.623 l
236.88 449.903 l
236.76 449.062 l
236.76 443.902 l
236.88 443.062 l
236.88 442.222 l
237.12 440.542 l
237.12 439.822 l
237.24 438.862 l
237.36 438.142 l
237.48 437.302 l
237.72 436.342 l
237.84 435.742 l
238.08 434.061 l
238.32 433.221 l
238.56 432.621 l
238.8 431.781 l
239.04 431.061 l
239.16 430.221 l
239.4 429.381 l
239.76 428.661 l
240.24 427.221 l
240.6 426.381 l
240.84 425.661 l
241.56 424.221 l
241.8 423.621 l
242.28 422.901 l
243 421.461 l
243.6 422.781 l
243.96 423.501 l
244.2 424.221 l
244.56 424.941 l
244.8 425.661 l
245.16 426.261 l
245.4 427.101 l
245.64 427.701 l
245.88 428.541 l
246.36 429.981 l
246.6 430.821 l
246.84 431.541 l
246.96 432.381 l
247.2 432.981 l
247.44 433.822 l
247.56 434.542 l
247.68 435.502 l
247.8 436.222 l
248.16 437.062 l
248.28 437.902 l
248.4 438.622 l
248.52 439.582 l
248.52 440.302 l
248.76 441.982 l
248.76 443.662 l
248.88 444.502 l
248.88 447.982 l
248.76 448.702 l
248.76 450.503 l
248.52 452.183 l
248.52 452.903 l
248.4 453.863 l
248.28 454.583 l
248.16 455.423 l
247.8 456.143 l
247.68 457.103 l
247.56 457.823 l
247.44 458.663 l
247.2 459.383 l
246.96 460.223 l
246.84 461.063 l
246.6 461.783 l
246.36 462.623 l
246.12 463.223 l
245.88 464.063 l
245.64 464.783 l
245.16 466.464 l
244.8 467.064 l
244.56 467.904 l
244.2 468.624 l
243.96 469.344 l
243.6 469.944 l
243.36 470.784 l
243 471.504 l
W n
q
9.9164 0 0 -12.1208 237.8618 433.5815 cm
/Im6 Do
Q
Q
0 0 0 RG
0.96 w
243 471.504 m
242.28 470.064 l
241.8 469.464 l
241.56 468.624 l
241.2 468.024 l
240.84 467.184 l
240.6 466.464 l
240.24 465.744 l
240 464.904 l
239.76 464.303 l
239.4 463.463 l
239.16 462.863 l
239.04 462.023 l
238.8 461.183 l
238.56 460.463 l
238.32 459.623 l
238.08 458.903 l
237.72 456.383 l
237.48 455.783 l
237.36 454.823 l
237.24 453.983 l
237.12 453.263 l
237.12 452.303 l
237 451.583 l
236.88 450.623 l
236.88 449.903 l
236.76 449.062 l
236.76 443.902 l
236.88 443.062 l
236.88 442.222 l
237.12 440.542 l
237.12 439.822 l
237.24 438.862 l
237.36 438.142 l
237.48 437.302 l
237.72 436.342 l
237.84 435.742 l
238.08 434.061 l
238.32 433.221 l
238.56 432.621 l
238.8 431.781 l
239.04 431.061 l
239.16 430.221 l
239.4 429.381 l
239.76 428.661 l
240.24 427.221 l
240.6 426.381 l
240.84 425.661 l
241.56 424.221 l
241.8 423.621 l
242.28 422.901 l
243 421.461 l
243.6 422.781 l
243.96 423.501 l
244.2 424.221 l
244.56 424.941 l
244.8 425.661 l
245.16 426.261 l
245.4 427.101 l
245.64 427.701 l
245.88 428.541 l
246.36 429.981 l
246.6 430.821 l
246.84 431.541 l
246.96 432.381 l
247.2 432.981 l
247.44 433.822 l
247.56 434.542 l
247.68 435.502 l
247.8 436.222 l
248.16 437.062 l
248.28 437.902 l
248.4 438.622 l
248.52 439.582 l
248.52 440.302 l
248.76 441.982 l
248.76 443.662 l
248.88 444.502 l
248.88 447.982 l
248.76 448.702 l
248.76 450.503 l
248.52 452.183 l
248.52 452.903 l
248.4 453.863 l
248.28 454.583 l
248.16 455.423 l
247.8 456.143 l
247.68 457.103 l
247.56 457.823 l
247.44 458.663 l
247.2 459.383 l
246.96 460.223 l
246.84 461.063 l
246.6 461.783 l
246.36 462.623 l
246.12 463.223 l
245.88 464.063 l
245.64 464.783 l
245.16 466.464 l
244.8 467.064 l
244.56 467.904 l
244.2 468.624 l
243.96 469.344 l
243.6 469.944 l
243.36 470.784 l
243 471.504 l
127.2 454.463 m
237.12 454.463 l
237.12 454.703 l
384.72 446.542 l
127.2 438.742 m
234.24 438.742 l
385.56 446.422 l
S
BT
14.04 0 0 14.0409 359.0396 489.505 Tm
0 0 0 rg
-0.002 Tc
-0.0025 Tw
[(Point of)6.2( )-8.6(F)10.7(o)2.2(cus)]TJ
ET
0 J
406.8 484.345 m
390.24 452.903 l
S
386.64 455.183 m
386.64 445.702 l
394.2 451.223 l
f*
BT
20.04 0 0 20.0413 244.0796 191.4058 Tm
-0.0003 Tc
0 Tw
[(Astigma)4.8(ti)8.2(sm)]TJ
-3.6886 -1.018 TD
-0.0009 Tc
-0.0017 Tw
[(\(irr)4.9(egular)4.9( cor)4.9(n)-6.7(e)4.2(al curvatur)4.9(e)-0.4(\))]TJ
ET
0.801 0.801 1 rg
0.5 0.5 0.5 RG
1 J 2.28 w
309.72 273.131 m
309.72 293.772 289.56 310.454 264.72 310.454 c
239.76 310.454 219.72 293.772 219.72 273.131 c
219.72 252.49 239.76 235.689 264.72 235.689 c
289.56 235.689 309.72 252.49 309.72 273.131 c
b*
362.76 273.131 m
362.76 306.973 333.72 334.455 297.96 334.455 c
262.2 334.455 233.28 306.973 233.28 273.131 c
233.28 239.289 262.2 211.687 297.96 211.687 c
333.72 211.687 362.76 239.289 362.76 273.131 c
b*
305.64 271.691 m
305.64 291.252 286.56 307.213 263.16 307.213 c
239.64 307.213 220.56 291.252 220.56 271.691 c
220.56 252.13 239.64 236.169 263.16 236.169 c
286.56 236.169 305.64 252.13 305.64 271.691 c
f*
q
238.32 297.571 12.13 -23.871 re
W n
238.32 297.733 12 -23.642 re
W n
244.56 297.733 m
243.84 296.413 l
243.48 295.693 l
243.24 294.853 l
242.88 294.253 l
242.4 293.412 l
242.16 292.692 l
241.8 291.972 l
241.56 291.132 l
241.32 290.532 l
240.96 289.692 l
240.72 289.092 l
240.6 288.252 l
240.36 287.532 l
239.88 285.852 l
239.64 285.132 l
239.28 282.612 l
239.04 282.012 l
238.92 281.052 l
238.8 280.332 l
238.68 279.492 l
238.68 278.652 l
238.56 277.811 l
238.44 276.851 l
238.44 276.131 l
238.32 275.291 l
238.32 270.131 l
238.44 269.291 l
238.44 268.451 l
238.68 266.771 l
238.68 266.051 l
238.8 265.091 l
238.92 264.491 l
239.04 263.531 l
239.28 262.69 l
239.4 261.97 l
239.64 260.29 l
239.88 259.45 l
240.12 258.85 l
240.36 258.01 l
240.6 257.29 l
240.72 256.45 l
240.96 255.61 l
241.32 254.89 l
241.8 253.45 l
242.16 252.61 l
242.4 252.01 l
242.88 251.17 l
243.24 250.45 l
243.48 249.85 l
244.56 247.69 l
245.16 249.01 l
245.52 249.73 l
245.76 250.45 l
246.12 251.17 l
246.36 251.89 l
246.72 252.49 l
246.96 253.33 l
247.2 253.93 l
247.44 254.77 l
247.92 256.21 l
248.16 257.05 l
248.4 257.77 l
248.52 258.61 l
248.76 259.21 l
249 260.05 l
249.24 261.73 l
249.36 262.451 l
249.6 263.291 l
249.72 264.131 l
249.84 264.851 l
249.96 265.811 l
249.96 266.531 l
250.2 268.211 l
250.2 269.891 l
250.32 270.731 l
250.32 274.211 l
250.2 275.051 l
250.2 276.731 l
249.96 278.411 l
249.96 279.132 l
249.84 280.092 l
249.72 280.812 l
249.6 281.652 l
249.36 282.372 l
249.24 283.332 l
249.12 284.052 l
249 284.892 l
248.76 285.732 l
248.52 286.452 l
248.4 287.292 l
248.16 288.012 l
247.92 288.852 l
247.68 289.452 l
247.44 290.292 l
247.2 291.012 l
246.72 292.692 l
246.36 293.292 l
246.12 294.133 l
245.76 294.853 l
245.52 295.573 l
245.16 296.293 l
244.92 297.013 l
244.56 297.733 l
W n
q
12 0 0 -23.6415 238.32 297.7327 cm
/Im4 Do
Q
Q
q
244.56 297.733 m
243.84 296.413 l
243.48 295.693 l
243.24 294.853 l
242.88 294.253 l
242.4 293.412 l
242.16 292.692 l
241.8 291.972 l
241.56 291.132 l
241.32 290.532 l
240.96 289.692 l
240.72 289.092 l
240.6 288.252 l
240.36 287.532 l
239.88 285.852 l
239.64 285.132 l
239.28 282.612 l
239.04 282.012 l
238.92 281.052 l
238.8 280.332 l
238.68 279.492 l
238.68 278.652 l
238.56 277.811 l
238.44 276.851 l
238.44 276.131 l
238.32 275.291 l
238.32 270.131 l
238.44 269.291 l
238.44 268.451 l
238.68 266.771 l
238.68 266.051 l
238.8 265.091 l
238.92 264.491 l
239.04 263.531 l
239.28 262.69 l
239.4 261.97 l
239.64 260.29 l
239.88 259.45 l
240.12 258.85 l
240.36 258.01 l
240.6 257.29 l
240.72 256.45 l
240.96 255.61 l
241.32 254.89 l
241.8 253.45 l
242.16 252.61 l
242.4 252.01 l
242.88 251.17 l
243.24 250.45 l
243.48 249.85 l
244.56 247.69 l
245.16 249.01 l
245.52 249.73 l
245.76 250.45 l
246.12 251.17 l
246.36 251.89 l
246.72 252.49 l
246.96 253.33 l
247.2 253.93 l
247.44 254.77 l
247.92 256.21 l
248.16 257.05 l
248.4 257.77 l
248.52 258.61 l
248.76 259.21 l
249 260.05 l
249.24 261.73 l
249.36 262.451 l
249.6 263.291 l
249.72 264.131 l
249.84 264.851 l
249.96 265.811 l
249.96 266.531 l
250.2 268.211 l
250.2 269.891 l
250.32 270.731 l
250.32 274.211 l
250.2 275.051 l
250.2 276.731 l
249.96 278.411 l
249.96 279.132 l
249.84 280.092 l
249.72 280.812 l
249.6 281.652 l
249.36 282.372 l
249.24 283.332 l
249.12 284.052 l
249 284.892 l
248.76 285.732 l
248.52 286.452 l
248.4 287.292 l
248.16 288.012 l
247.92 288.852 l
247.68 289.452 l
247.44 290.292 l
247.2 291.012 l
246.72 292.692 l
246.36 293.292 l
246.12 294.133 l
245.76 294.853 l
245.52 295.573 l
245.16 296.293 l
244.92 297.013 l
244.56 297.733 l
W* n
0.996 0.996 0.996 rg
238.32 274.091 12 -2.88 re
f
Q
q
238.32 271.042 12.065 -23.742 re
W n
238.32 271.211 12 -23.522 re
W n
244.56 297.733 m
243.84 296.413 l
243.48 295.693 l
243.24 294.853 l
242.88 294.253 l
242.4 293.412 l
242.16 292.692 l
241.8 291.972 l
241.56 291.132 l
241.32 290.532 l
240.96 289.692 l
240.72 289.092 l
240.6 288.252 l
240.36 287.532 l
239.88 285.852 l
239.64 285.132 l
239.28 282.612 l
239.04 282.012 l
238.92 281.052 l
238.8 280.332 l
238.68 279.492 l
238.68 278.652 l
238.56 277.811 l
238.44 276.851 l
238.44 276.131 l
238.32 275.291 l
238.32 270.131 l
238.44 269.291 l
238.44 268.451 l
238.68 266.771 l
238.68 266.051 l
238.8 265.091 l
238.92 264.491 l
239.04 263.531 l
239.28 262.69 l
239.4 261.97 l
239.64 260.29 l
239.88 259.45 l
240.12 258.85 l
240.36 258.01 l
240.6 257.29 l
240.72 256.45 l
240.96 255.61 l
241.32 254.89 l
241.8 253.45 l
242.16 252.61 l
242.4 252.01 l
242.88 251.17 l
243.24 250.45 l
243.48 249.85 l
244.56 247.69 l
245.16 249.01 l
245.52 249.73 l
245.76 250.45 l
246.12 251.17 l
246.36 251.89 l
246.72 252.49 l
246.96 253.33 l
247.2 253.93 l
247.44 254.77 l
247.92 256.21 l
248.16 257.05 l
248.4 257.77 l
248.52 258.61 l
248.76 259.21 l
249 260.05 l
249.24 261.73 l
249.36 262.451 l
249.6 263.291 l
249.72 264.131 l
249.84 264.851 l
249.96 265.811 l
249.96 266.531 l
250.2 268.211 l
250.2 269.891 l
250.32 270.731 l
250.32 274.211 l
250.2 275.051 l
250.2 276.731 l
249.96 278.411 l
249.96 279.132 l
249.84 280.092 l
249.72 280.812 l
249.6 281.652 l
249.36 282.372 l
249.24 283.332 l
249.12 284.052 l
249 284.892 l
248.76 285.732 l
248.52 286.452 l
248.4 287.292 l
248.16 288.012 l
247.92 288.852 l
247.68 289.452 l
247.44 290.292 l
247.2 291.012 l
246.72 292.692 l
246.36 293.292 l
246.12 294.133 l
245.76 294.853 l
245.52 295.573 l
245.16 296.293 l
244.92 297.013 l
244.56 297.733 l
W n
q
12 0 0 -23.5215 238.32 271.2111 cm
/Im7 Do
Q
Q
0 0 0 RG
0.96 w
244.56 297.733 m
243.84 296.413 l
243.48 295.693 l
243.24 294.853 l
242.88 294.253 l
242.4 293.412 l
242.16 292.692 l
241.8 291.972 l
241.56 291.132 l
241.32 290.532 l
240.96 289.692 l
240.72 289.092 l
240.6 288.252 l
240.36 287.532 l
239.88 285.852 l
239.64 285.132 l
239.28 282.612 l
239.04 282.012 l
238.92 281.052 l
238.8 280.332 l
238.68 279.492 l
238.68 278.652 l
238.56 277.811 l
238.44 276.851 l
238.44 276.131 l
238.32 275.291 l
238.32 270.131 l
238.44 269.291 l
238.44 268.451 l
238.68 266.771 l
238.68 266.051 l
238.8 265.091 l
238.92 264.491 l
239.04 263.531 l
239.28 262.69 l
239.4 261.97 l
239.64 260.29 l
239.88 259.45 l
240.12 258.85 l
240.36 258.01 l
240.6 257.29 l
240.72 256.45 l
240.96 255.61 l
241.32 254.89 l
241.8 253.45 l
242.16 252.61 l
242.4 252.01 l
242.88 251.17 l
243.24 250.45 l
243.48 249.85 l
244.56 247.69 l
245.16 249.01 l
245.52 249.73 l
245.76 250.45 l
246.12 251.17 l
246.36 251.89 l
246.72 252.49 l
246.96 253.33 l
247.2 253.93 l
247.44 254.77 l
247.92 256.21 l
248.16 257.05 l
248.4 257.77 l
248.52 258.61 l
248.76 259.21 l
249 260.05 l
249.24 261.73 l
249.36 262.451 l
249.6 263.291 l
249.72 264.131 l
249.84 264.851 l
249.96 265.811 l
249.96 266.531 l
250.2 268.211 l
250.2 269.891 l
250.32 270.731 l
250.32 274.211 l
250.2 275.051 l
250.2 276.731 l
249.96 278.411 l
249.96 279.132 l
249.84 280.092 l
249.72 280.812 l
249.6 281.652 l
249.36 282.372 l
249.24 283.332 l
249.12 284.052 l
249 284.892 l
248.76 285.732 l
248.52 286.452 l
248.4 287.292 l
248.16 288.012 l
247.92 288.852 l
247.68 289.452 l
247.44 290.292 l
247.2 291.012 l
246.72 292.692 l
246.36 293.292 l
246.12 294.133 l
245.76 294.853 l
245.52 295.573 l
245.16 296.293 l
244.92 297.013 l
244.56 297.733 l
133.8 283.692 m
230.76 283.692 l
230.76 283.932 l
360.72 273.251 l
133.8 263.291 m
228.12 263.291 l
361.44 273.371 l
136.8 277.931 m
217.44 277.931 l
217.44 278.051 l
325.56 273.011 l
136.8 268.091 m
215.28 268.091 l
326.28 273.011 l
S
BT
14.04 0 0 14.0409 358.3196 313.4537 Tm
0 0 0 rg
-0.0044 Tc
0.0085 Tw
[(Points o)8.3(f)-4.7( )8.6(Focus)]TJ
ET
0 J
405.72 308.293 m
334.56 275.411 l
S
333 279.372 m
327.12 271.931 l
336.48 271.571 l
f*
404.64 308.653 m
367.2 278.532 l
S
364.68 282.132 m
360.84 273.491 l
370.08 275.411 l
f*
BT
9.96 0 0 9.9606 113.1597 135.0023 Tm
0.0006 Tc
-0.0015 Tw
[(Figur)4.1(e 1:)]TJ
/F7 1 Tf
4.2289 0 TD
-0.0016 Tc
0.0007 Tw
[( T)-5.1(he th)12.2(r)-6(ee m)-12(o)0.2(st c)-7.6(o)0.2(mm)-12(on types)-7.6( of)11.3( r)-6(e)0.2(fr)-5.9(ac)-7.6(ti)-8.5(ve c)-7.6(o)12.2(ndi)-8.5(ti)-8.5(o)12.2(n)0.2(s)-7.6(,)-0.7( my)-7.6(opi)-8.5(a)12.2(,)-0.7( hy)-7.6(pe)12.2(r)-18(o)12.2(pi)-8.5(a,)]TJ
-4.2289 -1.3976 TD
-0.0022 Tc
-0.0107 Tw
[(and as)-8.2(ti)-9.1(g)11.6(m)-12.6(ati)-9.1(sm)]TJ
12 0 0 12.0008 185.6396 121.0813 Tm
0 Tc
0 Tw
(.)Tj
ET
q
92.04 738 411 -623.04 re
W n
1 J 0 j 1.44 w
93.96 148.443 408 588.038 re
S
EMC
Q
Q
endstream
endobj
41 0 obj
<<
/ProcSet [/PDF /Text /ImageC /ImageI]
/Font <<
/F1 4 0 R
/F3 20 0 R
/F7 24 0 R
>>
/XObject <<
/Im2 42 0 R
/Im3 43 0 R
/Im4 44 0 R
/Im5 45 0 R
/Im6 46 0 R
/Im7 47 0 R
>>
/ExtGState <<
/GS4 34 0 R
/GS6 48 0 R
>>
/ColorSpace <<
/Cs9 49 0 R
/Cs10 50 0 R
/Cs11 51 0 R
/Cs12 52 0 R
/Cs13 53 0 R
/Cs14 54 0 R
>>
/Properties <<
/MC2 38 0 R
>>
>>
endobj
55 0 obj
<<
/FunctionType 0
/Domain [0 1]
/Range [-1 1]
/BitsPerSample 16
/Size [256]
/Length 527
/Filter /FlateDecode
>>
stream
H
!"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~ ?
endstream
endobj
49 0 obj
[/Indexed /DeviceRGB 255 56 0 R]
endobj
56 0 obj
<<
/Length 183
/Filter /FlateDecode
>>
stream
H
E` ####!##+#dddds<}۶u]eyqa뺶m뺪,<˲4M$80 }