Long-term Effects of LASIK on Corneal Innervation and Tear Neuropeptides and the Associations With Dry Eye

Chao, Cecilia; Golebiowski, Blanka; Zhao, Xiangtian; Chen, Shihao; Zhou, Sheng; Stapleton, Fiona

doi:10.3928/1081597x-20160603-01

Cited by 44 publications

(41 citation statements)

References 23 publications

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“…Altered tear concentrations of nerve growth factor (NGF) and other neuropeptides, such as substance P (SP) and calcitonin gene-related peptide (CGRP), may also be key factors in LINE's pathophysiology [ 10 ]. Altered corneal nerve morphology parameters—lower nerve density, thinner width, fewer interconnections, and higher tortuosity—have been shown by in vivo laser scanning confocal microscopy at 6 to 12 months after LASIK, along with higher dry eye symptoms, CGRP levels, and conjunctival sensitivity with respect to nonoperated healthy eyes [ 28 ].…”

Section: Resultsmentioning

confidence: 99%

Autologous Platelet-Rich Plasma Eye Drops for the Treatment of Post-LASIK Chronic Ocular Surface Syndrome

Alió

Rodrı́guez

Abdelghany

et al. 2017

Journal of Ophthalmology

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Purpose To evaluate the efficacy of autologous platelet-rich plasma (E-PRP) eye drops for the treatment of chronic ocular surface syndrome (OSS) following laser in situ keratomileusis (LASIK). Methods This prospective interventional consecutive clinical study include 156 eyes of 80 patients affected by post-LASIK chronic OSS who were treated with autologous E-PRP 6 times a day as monotherapy for 6 weeks. Results Dry eye symptoms improved in 85% of the cases. A decrease in at least one quadrant to total disappearance on CFS was observed in 89.6% of the patients who had positive CFS before treatment. Three eyes presented severe punctate keratitis (1.9%) at baseline, all of which healed completely. Conjunctival hyperemia improved in 93.3% of the patients with previous signs of ocular surface inflammation. There was a significant improvement in logMAR CDVA from 0.14 ± 0.19 to 0.06 ± 0.12 (p = 0.000), and 74 (71.4%) eyes improved at least 1 line in CDVA. Conclusion Monotherapy with autologous E-PRP is a well-tolerated, safe, and effective treatment for the management of post-LASIK ocular surface syndrome. Precis Monotherapy with autologous platelet-rich plasma eye drops has been shown to be an adequate option for the treatment of post-LASIK chronic ocular surface syndrome. This trial is registered with NCT03322917.

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Section: Resultsmentioning

confidence: 99%

Autologous Platelet-Rich Plasma Eye Drops for the Treatment of Post-LASIK Chronic Ocular Surface Syndrome

Alió

Rodrı́guez

Abdelghany

et al. 2017

Journal of Ophthalmology

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“…The post-LASIK management was as previously described and reported. 18 The demographic information and clinic assessment have been reported in Chao et al 21 The study followed the tenets of the Declaration of Helsinki. Ethics approval was obtained from the University of New South Wales Sydney (Australia) Human Research Ethics Committee and the Wenzhou Medical University Human Research Review Board.…”

Section: Methodsmentioning

confidence: 99%

“…The corneal subbasal nerve plexus was imaged using an in vivo laser scanning confocal microscope (Heidelberg Retinal Tomograph II (HRTII) with Rostock Corneal Module (RCM); www.heidelbergengineering.co.uk). 21 In brief, approximately 150 images per subject were captured for a 1 mm 2 montage in all three regions. 18 Participants were asked to fixate on a specifically designed moving target to map a 1 mm 2 image of the corneal subbasal nerve plexus at the central cornea and approximately 2.5 mm mid-periphery (temporal and superior) away from the apex using the sequence mode.…”

Section: Methodsmentioning

confidence: 99%

“…20 However, regenerative corneal subbasal nerves are thinner, have fewer interconnections, and are more tortuous in subjects who had LASIK surgery compared to healthy controls. 18,21 We have previously reported qualitative changes to the corneal subbasal nerve pattern persisting 7 years after LASIK. 22 This study aimed to explore aspects of the post-LASIK subbasal nerve plexus architecture, namely the global nerve fibre orientation in the subbasal nerve plexus and the degree of variation.…”

Section: Introductionmentioning

confidence: 99%

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Alteration of the pattern of regenerative corneal subbasal nerves after laser in‐situ keratomileusis surgery

Chao

Lum

Golebiowski

et al. 2020

Ophthalmic Physiologic Optic

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Purpose Corneal nerves exhibit high plasticity, which allows successful reinnervation after nerve damage caused by laser in‐situ keratomileusis (LASIK) surgery. This study aimed to examine corneal subbasal nerve orientation during regeneration after LASIK. Methods This study involved 20 healthy, myopic subjects who had undergone bilateral Femto‐LASIK 12–16 months prior with a superior hinge position. The corneal subbasal nerve plexus at the central, mid‐temporal and mid‐superior cornea on the right eye were imaged using in vivo confocal microscopy. Global nerve fibre orientation (indicating the overall pattern) and variation of nerve fibre orientation (indicating the consistency of the orientation) was determined using customised MATLAB™ software (http://www.mathworks.com/products/matlab.html). Differences in nerve orientation variables between groups were examined using the Mann‐Whitney U test. Linear mixed models with Bonferroni adjustment were conducted to examine differences between corneal regions, and over time, after LASIK. Results There were no differences between post‐LASIK and control groups in global nerve orientation at any of the examined corneal regions. The post‐LASIK subjects had a greater variation of nerve orientation at the central (p = 0.007) and temporal (p = 0.049) cornea than the controls. There was a difference in global nerve fibre orientation between corneal regions (p < 0.001) in the controls but not in the post‐LASIK group. The variation of nerve fibre orientation was higher at the central, compared to the temporal and superior cornea after LASIK (p < 0.001), although there were no differences between corneal regions in controls. Conclusions Our results demonstrate that there was an increased variability in the corneal subbasal innervation patterns following LASIK when compared to controls.

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“…Conditions such as herpes simplex keratitis, Graves’ orbitopathy, and dry eye disease have all been shown to alter the sub‐basal nerve plexus. Similarly, contact lens wear and refractive surgery have been shown to affect properties of corneal nerves, with the latter demonstrating the ability of corneal nerves to regenerate. IVCM has also been used to assess the effect of ocular treatment modalities on corneal nerves; for example, following panretinal photocoagulation, dry eye treatment and following glaucoma therapy .…”

mentioning

confidence: 99%

Automatic analysis of corneal nerves imaged using in vivo confocal microscopy

Kim

Markoulli

2018

Clinical and Experimental Optometry

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Interest has grown over the past decade in using in vivo confocal microscopy to analyse the morphology of corneal nerves and their changes over time. Advances in computational modelling techniques have been applied to automate the estimation of sub-basal nerve structure. These objective methods have the potential to quantify nerve density (and length), tortuosity, variations in nerve thickness, as well as temporal changes in nerve fibres such as migration patterns. Different approaches to automated nerve analysis, methods proposed and how they were validated in previous literature are reviewed. Improved understanding of these approaches and their limitations will help improve the diagnostic leverage of emerging developments for monitoring the onset and progression of a broad class of systemic diseases, including diabetes.

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Long-term Effects of LASIK on Corneal Innervation and Tear Neuropeptides and the Associations With Dry Eye

Cited by 44 publications

References 23 publications

Autologous Platelet-Rich Plasma Eye Drops for the Treatment of Post-LASIK Chronic Ocular Surface Syndrome

Autologous Platelet-Rich Plasma Eye Drops for the Treatment of Post-LASIK Chronic Ocular Surface Syndrome

Alteration of the pattern of regenerative corneal subbasal nerves after laser in‐situ keratomileusis surgery

Automatic analysis of corneal nerves imaged using in vivo confocal microscopy

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