Subbasal nerve regeneration after LASEK measured by confocal microscopy. 2007

Taym Darwish, and Arun Brahma, and Nathan Efron, and Clare O'Donnell
Royal Eye Hospital, Manchester, United Kingdom. taym@scs-net.org

OBJECTIVE To determine the relationship between the degree of subbasal nerve regeneration and corneal sensation and tear film functions after LASEK using corneal confocal microscopy. METHODS This prospective, observational, and longitudinal study included 35 LASEK patients who underwent tear breakup time assessment, phenol red thread test, corneal esthesiometry, and confocal microscopy preoperatively and 1, 3, and 6 months postoperatively. Subbasal nerve images were analyzed to assess nerve regeneration. RESULTS Postoperatively, tear breakup time decreased significantly and had not returned to the preoperative level by 6 months after surgery. There were no significant differences in the phenol red thread test results before and after LASEK. Central corneal sensation decreased significantly 1 month after LASEK and returned to normal levels 3 months after surgery. Nerve fiber density, nerve branch density, and nerve fiber length and width decreased significantly after LASEK and had not returned to preoperative levels 6 months after surgery. Subbasal nerve fibers retained their vertical orientation after LASEK. There were no significant correlations between the length and density of subbasal nerve fibers and central corneal sensitivity, tear volume, or breakup time after surgery. CONCLUSIONS Subbasal nerves were injured by LASEK and had not returned to preoperative levels 6 months after surgery. Corneal sensitivity was reduced after LASEK and returned to normal levels 3 months after surgery.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009216 Myopia A refractive error in which rays of light entering the EYE parallel to the optic axis are brought to a focus in front of the RETINA when accommodation (ACCOMMODATION, OCULAR) is relaxed. This results from an overly curved CORNEA or from the eyeball being too long from front to back. It is also called nearsightedness. Nearsightedness,Myopias,Nearsightednesses
D009412 Nerve Fibers Slender processes of NEURONS, including the AXONS and their glial envelopes (MYELIN SHEATH). Nerve fibers conduct nerve impulses to and from the CENTRAL NERVOUS SYSTEM. Cerebellar Mossy Fibers,Mossy Fibers, Cerebellar,Cerebellar Mossy Fiber,Mossy Fiber, Cerebellar,Nerve Fiber
D009416 Nerve Regeneration Renewal or physiological repair of damaged nerve tissue. Nerve Tissue Regeneration,Nervous Tissue Regeneration,Neural Tissue Regeneration,Nerve Tissue Regenerations,Nervous Tissue Regenerations,Neural Tissue Regenerations,Regeneration, Nerve,Regeneration, Nerve Tissue,Regeneration, Nervous Tissue,Regeneration, Neural Tissue,Tissue Regeneration, Nerve,Tissue Regeneration, Nervous,Tissue Regeneration, Neural
D009882 Ophthalmic Nerve A sensory branch of the trigeminal (5th cranial) nerve. The ophthalmic nerve carries general afferents from the superficial division of the face including the eyeball, conjunctiva, upper eyelid, upper nose, nasal mucosa, and scalp. Nerve, Ophthalmic,Nerves, Ophthalmic,Ophthalmic Nerves
D010637 Phenolsulfonphthalein Red dye, pH indicator, and diagnostic aid for determination of renal function. It is used also for studies of the gastrointestinal and other systems. Phenol Red,Sulfonphthal,Sulphental,Sulphonthal
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003315 Cornea The transparent anterior portion of the fibrous coat of the eye consisting of five layers: stratified squamous CORNEAL EPITHELIUM; BOWMAN MEMBRANE; CORNEAL STROMA; DESCEMET MEMBRANE; and mesenchymal CORNEAL ENDOTHELIUM. It serves as the first refracting medium of the eye. It is structurally continuous with the SCLERA, avascular, receiving its nourishment by permeation through spaces between the lamellae, and is innervated by the ophthalmic division of the TRIGEMINAL NERVE via the ciliary nerves and those of the surrounding conjunctiva which together form plexuses. (Cline et al., Dictionary of Visual Science, 4th ed) Corneas
D004396 Coloring Agents Chemicals and substances that impart color including soluble dyes and insoluble pigments. They are used in INKS; PAINTS; and as INDICATORS AND REAGENTS. Coloring Agent,Dye,Dyes,Organic Pigment,Stain,Stains,Tissue Stain,Tissue Stains,Organic Pigments,Pigments, Inorganic,Agent, Coloring,Inorganic Pigments,Pigment, Organic,Pigments, Organic,Stain, Tissue,Stains, Tissue

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