ESCRS - FP07.09 - Study On Corneal Nerve Repair After Corneal Refractive Surgery Based On The Wide-Field Mosaic Analysis Of Corneal Subbasal Nerve Plexus

Study On Corneal Nerve Repair After Corneal Refractive Surgery Based On The Wide-Field Mosaic Analysis Of Corneal Subbasal Nerve Plexus

Published 2026 - 44th Congress of the ESCRS

Reference: FP07.09 | Type: Free paper | DOI: 10.82333/gnaw-yy28

Authors: Dr Yan Gao* 1 , Ms Rui Su 2

1Shanxi Eye Hospital,Taiyuan,China, 2Shanxi Medical University,Taiyuan,China

Purpose

To explore the application value of wide-field mosaic analysis of corneal subbasal nerve plexus in the evaluation of corneal nerve repair in patients undergoing corneal refractive surgery. The effects of SMILE, FS-LASIK, and PRK on corneal nerve morphology, perceptual function, and subjective symptoms were compared, providing a basis for clinical surgical procedure selection and postoperative management

Setting

This study was conducted at Shanxi Eye Hospital from July 2023 to July 2024. Seventy-five eligible patients who underwent corneal refractive surgery were enrolled and divided into three groups: SMILE , FS-LASIK , and PRK.  Corneal subbasal nerve morphology was evaluated via wide-field mosaic technique  to quantify CNFD, CNBD, CNFL before and at 6/12 months postoperatively. Corneal perception was detected by Cochet Bonnet in five regions. OSDI questionnaire assessed subjective symptoms. 

Methods

75 patients (75 eyes) who underwent corneal refractive surgery at Shanxi Eye Hospital from July 2023 to July 2024 were selected, including 26 eyes in SMILE group, 24 eyes in FS-LASIK group, and 25 eyes in PRK group. Using a wide-field mosaic technique combining manual stitching and deep learning algorithms, quantify corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) before and at 6 and 12 months after surgery. Cochet Bonnet corneal perceptron was used to detect the perceptual values of five corneal regions. Use OSDI questionnaire to assess patients' subjective symptoms.

Results

In terms of nerve repair, there was no significant difference in the CNFD values between the SMILE group before and 12 months after the operation, indicating complete recovery of the nerve vortex structure. The postoperative CNFD of FS-LASIK group and PRK group did not recover to preoperative levels. In terms of corneal perception, some areas of perception in the three groups slightly decreased at 6 months after surgery, and basically recovered to preoperative levels at 12 months. The OSDI scores of FS-LASIK group and PRK group significantly increased at 6 months after surgery, and decreased significantly at 12 months. Correlation analysis showed a weak positive correlation between corneal perception and neural parameters.

Conclusions

 Wide-field area mosaic technology can comprehensive assess corneal nerve repair status. There is a phenomenon of dissociation between corneal perception recovery and neural morphology repair. After comprehensive evaluation of neurological, subjective symptoms, SMILE surgery has less corneal nerve damage and faster postoperative repair.