Corneal sensation following excimer laser photorefractive keratectomy in humans

For the correction of myopia, small amounts of corneal tissue--including corneal nerves--are removed, resulting in flattening of the central cornea.

We studied the changes in corneal sensation in five regions of the cornea following photorefractive keratectomy at varying depths. We examined and compared the recovery of sensation in 17 sighted myopic eyes, with preoperative refractive ranges from -1.00 to -7.25 D. Eyes were divided into shallow (0 to 30 microns) or deep (31 to 70 microns) ablation groups depending on the attempted laser correction. Corneal sensation was measured in the central ablated area and the temporal, inferior, nasal, and superior unablated regions preoperatively and at 1, 3, and 6 months postoperatively.

Central and inferior sensation were significantly reduced in the deep ablations at 1 month and continued in the central cornea 6 months postoperatively. There were no overall differences in the sensations in the unablated nasal, temporal, and superior regions between either group or over time. There was a significant second order trend (p = .034) in these three regions, indicating a sharper increase in sensation from baseline in the deeper group at 1 month than the gradual upward trend of the shallow group.

Corneal sensation of both the central ablated area and the unablated peripheral cornea is decreased after deep anterior stromal excimer laser ablations and does not recover within 1 month. Although the deeper group showed isolated areas in the periphery of significant second order trends in sensation, the overall trends were not large, indicating no significant anesthetic effect. Fluctuations in sensation can be detected in the five regions even 6 months after excimer laser keratectomy. The clinical importance of these data remain to be defined.