ESCRS - PP21.09 - Epithelial, Corneal Nerves And Stromal Wound Healing Post Lenticular Extraction Using New Femtosecond Laser

Epithelial, Corneal Nerves And Stromal Wound Healing Post Lenticular Extraction Using New Femtosecond Laser

Published 2023 - 41st Congress of the ESCRS

Reference: PP21.09 | Type: Free paper | DOI: 10.82333/8y30-3r87

Authors: Rohit Shetty* 1 , Pooja Khamar 1 , Abhijit Sinha Roy 2 , Abhijit Sinha Roy 2 , Raghav Narasimhan 2

1Narayana Nethralaya,Bengaluru,India, 2IBMS,Narayana Nethralaya,Bengaluru,India

Purpose

To evaluate and quantify corneal nerve regeneration, epithelial remodelling, and structural collagen changes after lenticular extraction with new femtosecond laser platform (NFS) and compare with existing technology for small incision lenticule extraction (SMILE).

Setting

Tertiary Eye Hospital, Bengaluru, India

Methods

Eighty-four patients who underwent lenticule extraction with NFS (n=42) and SMILE (n=42) were prospectively evaluated. The corneal nerve fibre density (CNFD) and corneal nerve fibre length (CNFL), and keratocyte density (KD) were assessed using in vivo confocal microscopy (IVCM) . The speckle distribution of the cornea was assessed using polarization sensitive optical coherence tomography (PSOCT).The epithelium thickness was also measured.  Examinations were performed preoperatively and at 1, 3 and 6 months after surgery.

Results

The preoperative CNFD and CNFL were similar in both the groups (p>0.05). The change in CNFD was significantly lesser in the NFS group compared to the SMILE group at 1 month (-14.06/mm3 in NFS vs -17.98/mm3 in SMILE), 3 months (-10.59/mm3 in NFS vs -18.81/mm3 in SMILE) and 6 months (-11.80/mm3 in NFS vs -15.65/mm3 in SMILE) postoperatively. Similarly, change in CNFL and KD was significantly lesser in the NFS group compared to the SMILE group at 1, 3 and 6 months postoperatively. There was no significant post-operative change in the epithelial thickness and the corneal speckle distribution from preoperative values in the NFS group.

Conclusions

The NFS group demonstrated faster postoperative nerve regeneration, minimal keratocyte density and no significant change in the epithelial thickness and the corneal speckle distribution suggesting better postoperative wound healing.