Corneal sensitivity and nerve regeneration after excimer laser ablation

We studied the recovery of corneal sensitivity and corneal regeneration after excimer laser and manual epithelial debridement. The corneal epithelia of right eyes of New Zealand white rabbits (n = 21) were manually debrided and the corneal epithelia of the left eyes were ablated with the excimer laser (47 mm depth, 5 Hz, and 160 mJ/cm2). The relative density of innervation on the intraepithelial layer was measured using gold chloride staining and light microscopy. Wound healing and corneal sensitivity also were observed. Laser-ablated corneal sensitivity increased rapidly to a normal level by day 5, then increased gradually and reached a maximum at day 42. It remained elevated until 126 days, then returned to normal at 210 days. There were significant differences in the recovery of sensitivity after excimer ablation and manual epithelial removal. At day 35, relative density of innervation in the intraepithelial layer treated with excimer laser ablation was significantly higher than that treated with manual debridement. We observed a correlation between increased sensitivity and increased nerve density after excimer ablation. Compared with manual debridement, laser treatment resulted in an increase in networks of axons with terminal endings. This may not be the only factor correlating directly with hypersensitivity after corneal debridement, but it may indicate a quicker recovery route by using a presurgical manual debridement technique.