Comparison of deep anterior lamellar keratoplasty and penetrating keratoplasty with respect to postoperative corneal sensitivity and tear film function

Lin, Xiaolei; Xu, Binbin; Sun, Yifang; Zhong, Jing; Huang, Weilan; Yuan, Jing

doi:10.1007/s00417-014-2748-6

Cited by 28 publications

(20 citation statements)

References 41 publications

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“…up to 12 months after surgery ,[6] but NK is not very frequent in after this kind of surgery. (Lin et al, 2014) Collagen crosslinking for keratoconus.…”

Section: Acknowledgementsmentioning

confidence: 99%

Neurotrophic keratopathy

Dua

Said

Messmer

et al. 2018

Progress in Retinal and Eye Research

287

356

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Neurotrophic Keratopathy (NK) refers to a condition where corneal epitheliopathy leading to frank epithelial defect with or without stromal ulceration (melting) is associated with reduced or absent corneal sensations. Sensory nerves serve nociceptor and trophic functions, which can be affected independently or simultaneously. Loss of trophic function and consequent epithelial breakdown exposes the stroma making it susceptible to enzymatic degradation. Nerve pathology can range from attrition to aberrant re-generation with corresponding symptoms from anaesthesia to hyperaesthesia/allodynia. Many systemic and ocular conditions, including surgery and preserved medications can lead to NK. NK can be mild (epithelium and tear film changes), moderate (non-healing epithelial defect) or severe (stromal melting and perforation). Moderate and severe NK can profoundly affect vision and adversely impact on the quality of life. Medical management with lubricating agents from artificial tears to serum/plasma drops, anti-inflammatory agents, antibiotics and anti-proteases all provide non-specific relief, which may be temporary. Contact lenses, punctal plugs, lid closure with botulinum toxin and surgical interventions like tarsorrhaphy, conjunctival flaps and amniotic membrane provide greater success but often at the cost of obscuring sight. Corneal surgery in a dry ocular surface with reduced sensation is at high risk of failure. The recent advent of biologicals such as biopolymers mimicking heparan sulfate; coenzyme Q10 and antisense oligonucleotide that suppress connexin 43 expression, all offer promise. Recombinant nerve growth factor (cenegermin), recently approved for human use targets the nerve pathology and has the potential of addressing the underlying deficit and becoming a specific therapy for NK.

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“…up to 12 months after surgery ,[6] but NK is not very frequent in after this kind of surgery. (Lin et al, 2014) Collagen crosslinking for keratoconus.…”

Section: Acknowledgementsmentioning

confidence: 99%

Neurotrophic keratopathy

Dua

Said

Messmer

et al. 2018

Progress in Retinal and Eye Research

287

356

View full text Add to dashboard Cite

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“…115–118 One of the prime reasons for the popularity of this device is its portability and ease of use. However, the Cochet-Bonnet esthesiometer is less than ideal for its intended purpose due to its design, limited stimulus intensity range, user-dependency, variation in stimulus delivered, restrictive stimulation of only mechanoreceptors, and lack of reproducibly measuring corneal sensation at low thresholds of stimuli.…”

Section: Assessment Of the Subbasal Corneal Nerve Plexusmentioning

confidence: 99%

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

2017

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In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to that of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, and proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases.

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“…Dry eye is one of the common postoperative complications of corneal transplantation and may be associated with multiple mechanisms (Lin et al, 2014). During corneal-related surgery, the afferent nerve fibers of the cornea are severed, which may interrupt the cornea-trigeminal nerve-brainstem-facial nerve-lacrimal gland reflex arc and result in decreased tear secretion (Xie, 2016).…”

Section: Introductionmentioning

confidence: 99%