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Corneal Sensitivity After Ocular Surgery.

Edward Lum1, Melanie C Corbett, Paul J Murphy

  • 1School of Optometry and Vision Science (E.L.), The University of New South Wales, Sydney, Australia; The Western Eye Hospital (M.C.C.), Imperial Healthcare Trust, London, United Kingdom; School of Optometry and Vision Science (P.J.M.), University of Waterloo, Waterloo, Canada; and School of Optometry and Vision Sciences (P.J.M.), Cardiff University, Cardiff, United Kingdom.

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Summary

Corneal nerve endings provide sensitivity and support healing. Damage from disease or surgery can impair function, but sensation often recovers, except after certain corneal transplants.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Corneal Biology

Background:

  • The cornea possesses dense free nerve endings crucial for sensitivity and tissue support.
  • Impaired corneal nerve function due to disease, contact lens wear, or surgery can lead to corneal pathology and delayed healing.
  • Assessing corneal nerve function involves specialized aesthesiometers that utilize mechanical, chemical, or thermal stimuli.

Purpose of the Study:

  • To review the role of corneal innervation in ocular health.
  • To discuss the impact of ocular surgery on corneal nerve function.
  • To examine the patterns of corneal sensation loss and recovery following surgical procedures.

Main Methods:

  • Literature review focusing on corneal innervation and surgical outcomes.
  • Analysis of sensory assessment techniques using aesthesiometry.
  • Examination of factors influencing corneal nerve regeneration post-surgery.

Main Results:

  • Corneal nerve damage from surgery can significantly alter sensation.
  • Sensation typically recovers to preoperative levels after most surgeries with sufficient time.
  • Procedures like penetrating keratoplasty, epikeratophakia, and cryo-keratomileusis often result in incomplete sensory recovery.
  • The extent of nerve fiber damage and patient healing response dictate sensation loss and recovery patterns.

Conclusions:

  • Corneal nerve integrity is vital for maintaining ocular surface health and function.
  • While most corneal surgeries allow for eventual sensory recovery, specific procedures pose a higher risk of permanent deficits.
  • Understanding the relationship between surgical technique and nerve damage is key to managing patient outcomes and improving future surgical approaches.