From the Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital.
J Cataract Refract Surg. 2022 Jul 1;48(7):778-783. doi: 10.1097/j.jcrs.0000000000000872.
To evaluate the relationship between structural and functional changes of corneal subbasal nerves after single-step transepithelial photorefractive keratectomy (TransPRK).
Tianjin Medical University Eye Hospital.
Prospective observational study.
51 eligible candidates who underwent TransPRK for moderate myopia were included. The regeneration of corneal subbasal nerves were evaluated by in vivo confocal microscopy (IVCM) prior to surgery and at 1 week and 1 month, 3 months, 6 months, and 12 months postoperatively. The corneal sensitivity was measured by Cochet-Bonnet esthesiometer. The number of complete and incomplete blinks were recorded by LipiView interferometer. A correlation analysis was performed between these variables.
51 eyes of 51 patients were enrolled in this study. IVCM revealed that the density and length of corneal nerve decreased immediately and did not return to preoperative levels by 12 months post-TransPRK ( P < .01). The mean corneal sensitivity was slightly lower compared with preoperative levels at 1 week postoperatively ( P = .001) and then increased to baseline preoperative level within 1 month postoperatively. Mean total blink frequency and the partial blink rates had no statistically significant change postoperatively ( P = .087). There was no direct correlation between postoperative recovery of corneal sensitivity, changes in blink frequency, and regeneration of subbasal corneal nerve.
The significant and prolonged decrease in corneal subbasal nerve morphology was accompanied by only a slight and transient reduction in corneal sensitivity to mechanical stimuli within 1 month after TransPRK. The results demonstrated that the structural changes of subbasal nerves were not parallel to their functional changes after TransPRK.
评估一步式经上皮准分子激光角膜切削术（TransPRK）后角膜基底神经亚层的结构和功能变化之间的关系。
天津医科大学眼科医院。
前瞻性观察性研究。
纳入 51 例接受 TransPRK 治疗中度近视的患者。在术前以及术后 1 周、1 个月、3 个月、6 个月和 12 个月，通过活体共聚焦显微镜（IVCM）评估角膜基底神经亚层的再生情况。使用 Cochet-Bonnet 触觉计测量角膜敏感性。使用 LipiView 干涉仪记录完全眨眼和不完全眨眼的次数。对这些变量进行相关性分析。
本研究共纳入 51 例（51 只眼）患者。IVCM 显示，TransPRK 后即刻角膜神经的密度和长度下降，12 个月后仍未恢复到术前水平（P <.01）。术后 1 周时，平均角膜敏感性较术前略低（P =.001），术后 1 个月内逐渐恢复至术前水平。术后平均总眨眼频率和不完全眨眼率无统计学意义的变化（P =.087）。术后角膜敏感性恢复、眨眼频率变化与基底角膜神经再生之间无直接相关性。
TransPRK 后角膜基底神经形态显著且持续下降，仅在术后 1 个月内机械刺激引起的角膜敏感性出现轻微且短暂的下降。结果表明，TransPRK 后，基底神经的结构变化与功能变化并不平行。
