Official ESCRS | European Society of Cataract & Refractive Surgeons
Vienna 2018 Delegate Registration Programme Exhibition Virtual Exhibition Satellites 2018 Survey


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Corneal sub-basal nerve plexus analysis 10 years after LASIK surgery

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Session Details

Session Title: SMILE vs PRK, Ocular Surface Disease

Session Date/Time: Monday 24/09/2018 | 08:00-10:30

Paper Time: 09:34

Venue: Room A3, Podium 3

First Author: : P.Cañadas SPAIN

Co Author(s): :    R. Aranda   A. Rodero   G. Laucirica   A. Parafita   P. Drake   M. Garcia-Gonzalez     

Abstract Details


Corneal sub basal nerve plexus is the responsible to preserve the normal function and architecture of the corneal surface. This important sensory function is disrupted when nerves are cut during photorefractive procedures such as LASIK. In LASIK, the flap created with a microkeratome cuts the sub-basal nerve fiber bundles and the superficial stromal nerves, although nerves that run through the hinge are spared. This disruption is thought to contribute to dry eye and alterations in the tear film after these procedures.


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Methods: We analyzed the nerve morphology (number of nerves, density of nerves, density of nerve branches, and grade of nerve tortuosity) and the density of dendritic cells from the confocal images obtained with the Heidelberg Retina Tomograph II (HRTII). The number of nerves (n/ image) and the density of nerves (um/mm2) were measured using the plugin NeuronJ from the ImageJ software, which allows semi-automated tracing of nerve fibers and provides quantification. Nerve branches and dendritic cells, were manually counted and the density calculated (n/mm2). The grade of nerve tortuosity was evaluated subjectively and in an objective way.


In this study were included 47 eyes divided in two groups. One group of 20 eyes without refractive surgery and other group with 27 eyes that underwent LASIK at least 10 years before. We didn´t found statistically differences in the density of nerves, grade of nerve tortuosity, density of dendritic cells and nerve branches between groups.


In summary, the corneal nerves that are lost during LASIK slowly regenerate, and appear to return to preoperative densities by 10 years after LASIK surgery. The return is characterized by variations in the regeneration rate, with a decrease in number during the early post operatory.

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