Structural and functional changes of binocular corneal innervation and ocular surface function after unilateral SMILE and tPRK

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..

AIMS: To evaluate the bilateral changes in the sub-basal nerve plexus of the cornea and ocular surface function after unilateral small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) procedures.

METHODS: 34 patients were enrolled in the study and underwent unilateral SMILE (21 of 34 patients) or unilateral tPRK (13 of 34 patients). Complete ophthalmic examinations, tear film function tests and Cochet-Bonnet esthesiometry were conducted to assess the effects of the surgeries on the corneal nerves and tear function. Morphological changes were assessed using in vivo confocal microscopy to evaluate the corneal sub-basal nerve plexus and dendritic cells. ELISA was used to measure the tear neuromediators. Clinical and morphological data at each follow-up point were compared with preoperative baseline values.

RESULTS: All patients who underwent unilateral SMILE or tPRK procedures exhibited bilateral corneal nerve degenerative changes, decreased corneal sensitivity, worsening of dry eye symptoms and changes in bilateral tear neuromediators. In the SMILE group, bilateral corneal sensitivity was positively correlated with corneal nerve fibre length and negatively correlated with dendritic cell area. The dry eye severity was negatively correlated with corneal sensitivity. Tear levels of substance P and nerve growth factor were positively correlated with mean dendritic cell area and dry eye severity, but negatively correlated with corneal sensitivity. In the tPRK group, bilateral corneal sensitivity was positively correlated with corneal nerve fibre density.

CONCLUSIONS: Unilateral refractive surgery may bilaterally affect the morphology and function of corneal nerves and ocular surface status postoperatively.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

The British journal of ophthalmology - (2024) vom: 04. Apr.

Sprache:

Englisch

Beteiligte Personen:

Gong, Qianwen [VerfasserIn]
Huang, Kaiyan [VerfasserIn]
Li, Kexin [VerfasserIn]
Tong, Yixuan [VerfasserIn]
Zhao, Jian [VerfasserIn]
Wang, Hui [VerfasserIn]
Xu, Zhiqiang [VerfasserIn]
Lin, Meng [VerfasserIn]
Lu, Fan [VerfasserIn]
Hu, Liang [VerfasserIn]

Links:

Volltext

Themen:

Cornea
Journal Article
Ocular surface
Treatment Surgery

Anmerkungen:

Date Revised 04.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1136/bjo-2023-324358

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370173260