Comparison of corneal nerve regeneration and sensitivity between LASIK and laser epithelial keratomileusis (LASEK)
Comparison of corneal nerve regeneration and sensitivity between LASIK and laser epithelial keratomileusis (LASEK)
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DOI：
10.1016/j.ajo.2006.01.048
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发表时间：
2006-06-01
影响因子：
4.2
通讯作者：
Lee, Hyung Keun
中科院分区：
文献类型：
--
作者：
Lee, Seung Jae;Kim, Jin Kuk;Lee, Hyung Keun
目的：比较准分子激光原位角膜磨镶术(LASIK)和准分子激光上皮下角膜磨镶术(LASEK)术后角膜神经纤维和角膜细胞密度的变化。设计：前瞻性非随机对照临床试验。方法：共纳入LASIK患者28例6眼和LASK患者26例52眼共56只眼。结果：LASIK组术后6个月角膜敏感度较术前下降，术后3个月和6个月时角膜中央角膜共聚焦显微镜检查数据、角膜敏感度、泪膜破裂时间和Schirmer值均低于术前水平。然而，在LASEK组，基线值和术后6个月值之间没有差异。准分子激光原位角膜磨镶术和准分子激光原位角膜磨镶术组的基底下神经纤维数量和角膜基质细胞密度也不同。两组角膜神经再生与角膜知觉恢复及角膜基质细胞密度密切相关，而泪膜破裂时间、Schirmer值、角膜上皮厚度与角膜神经再生均无相关性。结论：LASIK组较LASEK组基底下神经纤维数量减少较多，可能与角膜敏感度下降较大有关。LASEK术后的角膜神经再生模式和角膜知觉的恢复与以往研究中的准分子激光屈光性角膜切削术相比差异不大。
PURPOSE: To compare changes in corneal nerve fibers and keratocyte density by confocal microscopy after laser-assisted in situ keratomileusis (LASIK) and laser epithelial keratomilcusis (LASEK). DESIGN: Prospective, nonrandomized comparative clinical trial.METHODS: Fifty,six eyes of 28 patients who underwent LASIK and 52 eyes of 26 patients who underwent LASEK were included. Confocal microscopic data of the central cornea, corneal sensitivity, tear film breakup time, and Schirmer values were determined at three and six months after LASIK or LASEK treatment.RESULTS: In the LASIK group, corneal sensitivity was reduced from preoperative levels at six months after surgery. In the LASEK group, however, there was no difference between baseline and six-month postoperative values. The number of subbasal nerve fibers and the keratocyte density were also different in the LASIK an LASEK groups. The regeneration of corneal nerves correlated strongly with the recovery of corneal sensation and keratocyte density in both groups, whereas the tear film breakup time, Schirmer values, and epithelial thickness did not correlate with corneal nerve regeneration in either group.CONCLUSIONS: The greater decrease in the number of subbasal nerve fibers in the LASIK group compared with the LASEK group may relate to the greater decrease in corneal sensitivity. The pattern of corneal nerve re generation and the recovery of corneal sensation after LASEK did not differ greatly from that after photorefractive keratectomy in previous studies.