Abstract
Background
Subepithelial nerve fibre bundles and stromal nerves are damaged during laser epithelial keratomileusis (LASEK). The aim of this study was to investigate the recovery of corneal sensation after LASEK for the correction of myopia.
Methods
Corneal sensation was evaluated in 40 eyes of 20 patients using a Cochet–Bonnet aesthesiometer before surgery and 3 days, 14 days, 1, 3 and 6 months after LASEK for the correction of mild to moderate myopia (range −2.5 D to −8.0 D). At every examination corneal sensation was tested in the apex of the cornea and in one point each at the 12, 3, 6 and 9 o’ clock positions 2 mm from the centre of the cornea.
Results
Corneal sensation was significantly reduced at 3 days and 14 days after surgery (P<0.01). The loss of corneal sensation was greatest 3 days after surgery and corneal sensation increased during the first month after LASEK. After 1 month, 3 months and 6 months no significant difference was found between preoperative and postoperative sensation. There was no significant difference in sensation between different areas of the cornea after LASEK.
Conclusions
Corneal nerves are disrupted during LASEK surgery and the procedure results in a significant reduction in corneal sensation. During the first month after surgery the depressed corneal sensation improved and subsequently went back to preoperative values, staying stable 3 months and 6 months after surgery.
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References
Autrata R, Rehurek J (2003) Laser-assisted subepithelial keratectomy for myopia: two-year follow-up. J Cataract Refract Surg 29:661–668
Battat D, Macri S, Dursun D, Pflugfelder S (2001) Effects of laser in situ keratomileusis on tear production, clearance and the ocular surface. Ophthalmology 108:1230–1235
Camellin M (1999) LASEK may offer the advantages of both LASIK and PRK. Ocul Surg News Int Ed 3:14–15
Carones T, Fiore T, Brancato R (1999) Mechanical vs alcohol epithelial removal during photorefractive keratectomy. J Refract Surg 15:556–562
Donnenfeld E, Solomon K, Perry H, Doshi S, Ehrenhaus M, Solomon R, Biser S (2003) The effect of hinge position on corneal sensation and dry eye after LASIK. Ophthalmology 110:1023–1030
Kauffmann HE, Barro HA, McDonald MB (1998) The cornea. Corneal innervation, 2nd edn. pp 23–26
Lawrenson J, Corbett M, O’Brat D, Marshall JE (1997) Effect on beam variables on corneal sensitivity after excimer laser photorefractive keratectomy. Br J Ophthalmol 81:686–690
Linna TU, Perez-Santonja JJ, Tervo KM, Sakla HF, Alio JL, Tervo TMT (1998) Recovery of corneal nerve morphology following laser in situ keratomileusis. Exp Eye Res 66:755–763
Lohmann CP, Winkler von Mohrenfels C, Gabler B, Herrmann W, Müller M (2002) Excimer Laser Subepitheliale Ablation (ELSA) bzw. Laser Subepitheliale Keratomileusis (LASEK)—Ein neuartiges refraktiv-chirurgisches Verfahren zur Myopiekorrektur. Operationstechnik und erste klinische Ergebnisse an 24 Augen und nach 3 Monaten. Klin Monatsbl Augenheilkd 219:26–32
Masters BR, Thaer AA (1994) In vivo human corneal confocal microscopy of identical fields of subepithelial nerve plexus, basal epithelial, and wing cells at different times. Microsc Res Tech 29:350–356
Matsui H, Kumano Y, Zushi I, Yamada T, Matsui T, Nshida T (2001) Corneal sensation after correction of myopia by photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg 27:370–373
Müller L, Marfurt C, Kruse F, Tervo T (2003) Corneal nerves: structure, contents and function. Exp Eye Res 76:521–542
Oliveira-Soto L, Efron N (2001) Morphology of corneal nerves using confocal microscopy. Cornea 20:374–384
Ozdamar A, Acras C, Karakas N, Sener B, Karacorlu M (1999) Changes in tear flow and tear film stability after photorefractive keratectomy. Cornea 18:437–439
Perez-Santonja J, Sakla H, Cardona C, Chipont E, Alio J (1999) Corneal sensitivity after photorefractive keratectomy and laser in situ keratomileusis for low myopia. Am J Ophthalmol 127:497–504
Pflugfelder SC, Tseng SCG, Sanabria O, Kell H, Garcia CG, Felix C, Reis BL (1998) Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea 17:584–589
Siganos DS, Popescu CN, Siganos CS, Pistola G (2000) Tear secretion following spherical and astigmatic excimer laser photorefractive keratectomy. J Cataract Refract Surg 26:1585–1589
Stern ME, Beuerman RW, Fox RI, Gao J, Mircheff AK, Pflugfelder SC (1998) The pathology of dry eye: the interaction between the ocular surface and lacrimal glands (review). Cornea 17:584–589
Toda I, Asano-Kato N, Komai-Hori Y, Tsubota K (1997) Dry eye after laser in situ keratomileusis. Korean J Ophthalmol 11:89–93
Wilson SE (2001) Laser in situ Keratomileusis-induced (presumed) neurotrophic epitheliopathy. Ophthalmology 108:1082–1087
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Herrmann, W.A., Shah, C., Gabler, B. et al. Corneal sensation after laser epithelial keratomileusis for the correction of myopia. Graefe's Arch Clin Exp Ophthalmol 243, 33–37 (2005). https://doi.org/10.1007/s00417-004-0974-z
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DOI: https://doi.org/10.1007/s00417-004-0974-z