[Corneal reinnervation after lamellar refractive corneal surgery]

Area of Science:

• Ophthalmology
• Corneal Surgery
• Vision Science

Background:

• Refractive autokeratoplasty aims to correct myopia by reshaping the cornea.
• Understanding corneal reinnervation is crucial for post-operative recovery and visual outcomes.
• Previous studies have explored corneal sensitivity changes after refractive surgery, but comparative data on different techniques is limited.

Purpose of the Study:

• To compare corneal sensitivity recovery after two types of refractive autokeratoplasty: keratomileusis in situ and keratomileusis myopica.
• To evaluate the timeline of corneal reinnervation and its correlation with visual outcomes.

Main Methods:

• A retrospective study involving 38 patients who underwent keratomileusis in situ and 18 patients who underwent keratomileusis myopica.
• Corneal sensitivity was measured using a Draeger esthesiometer at 1 to 23 months post-surgery.
• Measurements were taken at three points on the refractive disc and two on the untouched cornea.

Main Results:

• Corneal reinnervation was significantly delayed after keratomileusis myopica compared to keratomileusis in situ.
• Normal corneal sensitivity was restored within 2 years after keratomileusis in situ and within 1 year after keratomileusis myopica.
• Factors influencing recovery include cell repopulation, stromal metabolism, and refractive ablation depth.

Conclusions:

• The surgical technique significantly impacts corneal reinnervation timelines after refractive autokeratoplasty.
• Keratomileusis in situ demonstrates a more favorable recovery profile for corneal sensitivity.
• Corneal tissue metabolism and dissection depth are critical factors affecting post-operative recovery and visual function.