The Role of Corneal Innervation in LASIK-Induced Neuropathic Dry Eye
The Role of Corneal Innervation in LASIK-Induced Neuropathic Dry Eye
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DOI：
10.1016/j.jtos.2013.09.001
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发表时间：
2014-01-01
期刊：
影响因子：
6.4
通讯作者：
Stapleton, Fiona
中科院分区：
文献类型：
--
作者：
Chao, Cecilia;Golebiowski, Blanka;Stapleton, Fiona
几乎一半接受激光原位角膜磨镶术（LASIK）的患者在手术后会出现干眼症。然而，LASIK引起干眼症的病因尚不清楚。本文就眼表敏感性和角膜神经支配与LASIK术后干眼症病因的关系作一综述。有证据表明，LASIK术后角膜神经的改变是LASIK引起的干眼症的主观症状的最可能原因，尽管由于角膜神经丛的部分恢复，角膜敏感性和干眼症的临床指标在一年内恢复到明显的正常值。本文探讨了LASIK术后干眼症状可能是由于LASIK引起的角膜神经病变引起的感觉异常的假说。其他因素，如结膜杯状细胞密度的改变，也可能有助于LASIK诱导的干眼的症状和体征。神经形态、泪液神经肽水平和干眼症之间的相互关系需要进一步研究。更好地了解这种现象可能会导致LASIK术后干眼症的改善管理。
Almost half the patients who undergo laser in situ keratomileusis (LASIK) experience dry eye following the procedure. However, the etiology of LASIK-induced dry eye is unclear. The purpose of this review is to examine and summarize the current evidence for the etiology of LASIK-induced dry eye, with a focus on ocular surface sensitivity and corneal innervation. Evidence suggests that the alteration of corneal nerves after LASIK is the most likely cause of the subjective symptoms of LASIK-induced dry eye, even though corneal sensitivity and the clinical indicators of dry eye return to apparently normal values within a year due to the partial recovery of the corneal nerve plexus. The hypothesis is explored that dry eye symptoms following LASIK may result from abnormal sensation due to LASIK-induced corneal neuropathy. Other factors, such as alterations in conjunctival goblet cell density, might also contribute to the symptoms and signs of LASIK-induced dry eye. Interrelationships between nerve morphology, tear neuropeptide levels and dry eye require further investigation. A better understanding of this phenomenon may result in improved management of post-LASIK dry eye.