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Corneal sensitivity after epikeratophakia.

S B Koenig, R A Berkowitz, R W Beuerman

    Ophthalmology
    |October 1, 1983
    PubMed
    Summary
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    Epikeratophakia surgery can reduce corneal sensitivity, but sensitivity improves over time. Host corneal nerves may re-innervate the implanted lenticule, enhancing recovery.

    Area of Science:

    • Ophthalmology
    • Corneal Surgery
    • Neuroscience

    Background:

    • Epikeratophakia is a refractive surgical procedure involving the implantation of a corneal lenticule.
    • Understanding the neurosensory recovery after epikeratophakia is crucial for patient outcomes.

    Purpose of the Study:

    • To evaluate corneal sensitivity following epikeratophakia.
    • To investigate the relationship between postoperative recovery time and corneal sensitivity.
    • To explore the potential mechanisms of corneal nerve regeneration in epikeratophakia lenticules.

    Main Methods:

    • Corneal sensitivity was assessed in 60 eyes of 30 patients who underwent unilateral epikeratophakia.
    • Patients had undergone surgery for aphakia or keratoconus.
    • Histopathology of primate lenticules was examined to study nerve presence.

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    Main Results:

    • A relative hypesthesia (reduced sensitivity) was observed in the epikeratophakia lenticule compared to the host cornea.
    • Corneal sensitivity increased significantly in patients with over 1 year of postoperative recovery compared to those with less than 1 year.
    • Histopathology revealed sparse epithelial axon terminals in primate lenticules, suggesting limited initial innervation.

    Conclusions:

    • Epikeratophakia leads to a temporary reduction in corneal sensitivity.
    • Corneal sensitivity demonstrates improvement over time, indicating a potential for neurosensory recovery.
    • Host corneal nerves appear to re-innervate the lenticule through scar penetration and intraepithelial extension.