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Corneal reinnervation after LASIK: prospective 3-year longitudinal study
Martha P Calvillo1, Jay W McLaren, David O Hodge
1Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Investigative Ophthalmology & Visual Science
|October 27, 2004
Summary
Corneal nerve regeneration after laser-assisted in situ keratomileusis (LASIK) is slow, with subbasal nerves not fully recovering within three years. Nerve density decreases between years two and three post-LASIK surgery.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Neuroscience
Background:
- Laser-assisted in situ keratomileusis (LASIK) is a common refractive surgery.
- Understanding corneal reinnervation post-LASIK is crucial for patient outcomes.
Purpose of the Study:
- To quantify corneal nerve recovery over three years following LASIK.
- To assess changes in subbasal and stromal nerve density and orientation.
Main Methods:
- Confocal microscopy was used to examine 17 corneas from 11 patients before and at multiple time points after LASIK.
- Nerve fiber bundle count, density, orientation, and depth were measured.
Main Results:
- Subbasal and stromal nerves showed significant loss (>90%) one month post-LASIK.
- Nerve density began recovering by six months, nearing pre-LASIK levels by two years.
- However, subbasal nerve density decreased between years two and three, remaining below pre-LASIK levels (<60%) at three years.
- Stromal flap nerves recovered slowly, not reaching pre-LASIK numbers by three years.
- No significant changes were observed in the stromal bed.
Conclusions:
- Corneal nerve regeneration after LASIK is a slow process.
- Neither subbasal nor stromal nerves fully recover to pre-LASIK densities within three years.
- A decrease in subbasal nerve density occurs between two and three years post-LASIK.