Incision depth affects the recovery of corneal sensitivity and neural regeneration in the cat

To assess the effect of incision depth on the recovery of corneal sensitivity and neural regeneration, adult domestic cats underwent either 8-mm circular nonpenetrating keratotomies or penetrating autografts. The contralateral eye served as control. Corneal sensitivity was determined at various intervals after surgery. The depth of incision in the nonpenetrating keratotomies, assessed by optical pachometry, ranged between 49 and 91% of total corneal thickness. The animals were ranked based on the depth of incision and the average sensitivity within the keratotomy over the 1-yr recovery period. A significant negative correlation was found between incision depth and the recovery of sensitivity (Spearman rank-order correlation r = -0.84, P less than 0.05). Some recovery of sensitivity was found in the center and periphery of the incised zone when incision depth was less than 53% of total corneal thickness. With deeper incisions, the center of the incised zone remained insensitive throughout the measurement period, while the periphery of the incised zone showed a slight recovery of corneal sensitivity, proportional to incision depth. The recovery of corneal sensitivity was higher in a small annular region just distal to the incision site. When incision depth exceeded approximately 53%, gold chloride impregnation showed that the resultant reinnervation was confined to single intraepithelial axons or localized regions of irregular epithelial fibers. With shallower incisions, the deeper stromal trunks were spared, resulting in the persistence of a reduced subepithelial plexus and basal epithelial leashes. We have shown that when an incision severs all stromal trunks, the neural regeneration is insufficient for functional recovery of corneal sensitivity at the center of an 8-mm keratotomy.(ABSTRACT TRUNCATED AT 250 WORDS)