Confocal Comparison of Corneal Nerve Regeneration and Keratocyte Reaction between FS-LASIK, OUP-SBK, and Conventional LASIK

Zhang, Fengju; Deng, Shengfu; Guo, Ning; Wang, Meng Meng; Sun, Xing‐Guo

doi:10.1167/iovs.11-8786

Cited by 24 publications

(15 citation statements)

References 9 publications

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“…Patel et al [13] demonstrated that the postoperative subbasal nerve densities observed 12 months after FS-LASIK and conventional LASIK were significantly lower than the preoperative densities. Zhang et al [14] reported that corneal subbasal nerve fibers were detectable about 3 mm from the center of the flap in 62.5% of FS-LASIK-treated eyes at the 3-month visit and 100% of FS-LASIK-treated eyes at the 6-month visit. Consistent with previous studies, our results indicated that corneal subbasal nerve fibers were detectable in 56.6% of FS-LASIK-treated eyes at postoperative month 3 and in 100% of FS-LASIK-treated eyes at postoperative month 6.…”

Section: Discussionmentioning

confidence: 99%

Confocal Comparison of Corneal Reinnervation after Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser In Situ Keratomileusis (FS-LASIK)

et al. 2013

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PurposeTo evaluate corneal reinnervation, and the corresponding corneal sensitivity and keratocyte density after small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK).MethodsIn this prospective, non-randomized observational study, 18 patients (32 eyes) received SMILE surgery, and 22 patients (42 eyes) received FS-LASIK surgery to correct myopia. The corneal subbasal nerve density and microscopic morphological changes in corneal architecture were evaluated by confocal microscopy prior to surgery and at 1 week, 1 month, 3 months, and 6 months after surgery. A correlation analysis was performed between subbasal corneal nerve density and the corresponding keratocyte density and corneal sensitivity.ResultsThe decrease in subbasal nerve density was less severe in SMILE-treated eyes than in FS-LASIK-treated eyes at 1 week (P = 0.0147), 1 month (P = 0.0243), and 3 months (P = 0.0498), but no difference was detected at the 6-month visit (P = 0.5277). The subbasal nerve density correlated positively with central corneal sensitivity in both groups (r = 0.416, P<0.0001, and r = 0.2567, P = 0.0038 for SMILE group and FS-LASIK group, respectively). The SMILE-treated eyes have a lower risk of developing peripheral empty space with epithelial cells filling in (P = 0.0005).ConclusionsThe decrease in subbasal nerve fiber density was less severe in the SMILE group than the FS-LASIK group in the first 3 months following the surgeries. The subbasal nerve density was correlated with central corneal sensitivity.

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Section: Discussionmentioning

confidence: 99%

Confocal Comparison of Corneal Reinnervation after Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser In Situ Keratomileusis (FS-LASIK)

et al. 2013

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“…314–316 However, flaps created using One Use-Plus Sub-Bowman’s keratomileusis (OUP-SBK) had faster nerve regeneration compared to those created with a femtosecond laser or an M2 90 microkeratome. 315 Several studies have shown the effect of the hinge position on the recovery of corneal nerves and sensitivity. Nerve density diminishment varies in different regions within the LASIK flap, being spared on the side of the hinge, and influencing nerve regrowth and corneal sensitivity recovery.…”

Section: Corneal Nerve Alterations After Corneal Surgerymentioning

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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“…Long‐standing post‐operative corneal nerve damage may explain that some patients have persistent dry eye symptoms after surgery. The regeneration of corneal subbasal nerve fibres starts at one month after LASIK and the recovery begins in the peripheral cornea . Abnormal morphology and architecture of restored corneal nerves were noticed after LASIK .…”

Section: Aetiologymentioning

confidence: 99%

Recent advances in laser in situ keratomileusis‐associated dry eye

Xie

2016

Clinical and Experimental Optometry

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Dry eye is the most common complication after laser in situ keratomileusis (LASIK). The major cause of LASIK-associated dry eye is corneal nerve damage. Early identification and treatment of post-operative dry eye are essential to prevent further ocular surface damage. This article reviews the recent studies of LASIK-associated dry eye, including clinical features, aetiology, risk factors, evaluations and treatment. The applications of novel technologies in LASIK-associated dry eye evaluation like anterior segment spectral-domain optical coherence tomography (SD-OCT) and corneal confocal microscopy are also introduced in this review.

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Confocal Comparison of Corneal Nerve Regeneration and Keratocyte Reaction between FS-LASIK, OUP-SBK, and Conventional LASIK

Cited by 24 publications

References 9 publications

Confocal Comparison of Corneal Reinnervation after Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser In Situ Keratomileusis (FS-LASIK)

Confocal Comparison of Corneal Reinnervation after Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser In Situ Keratomileusis (FS-LASIK)

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

Recent advances in laser in situ keratomileusis‐associated dry eye

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