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Esben Nielsen, Anders Ivarsen, Jesper Hjortdal; Corneal nerve regeneration is linked to optical changes in patients with Fuchs’ endothelial corneal dystrophy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5711.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether changes in the corneal subbasal nerve plexus (SNP) is associated with changes in the optical quality of the anterior cornea after endothelial keratoplasty (DSAEK).
In a prospective controlled study, 41 FECD patients (FECD group, 41 eyes) and 40 cataract patients with normal corneas (Control group: 80 eyes) eligible for surgery (DSAEK and cataract surgery, respectively) were recruited. Patients were examined with Pentacam HR and in vivo confocal microscopy (IVCM). The FECD group was examined preOP, and at 3, 6 and 12 months after surgery (PostOP). The Control group was examined preOP and at 12 months postOP. Total central corneal thickness, anterior densitometry, anterior higher order aberrations and the density of the corneal sub basal nerve plexus (SNP) were entered into a repeated-measures mixed model.
In the FECD group, SNP density decreased significantly from preOP to 3 months postOP (p = 0.004), exhibited no significantly change from 3 to 6 months (p = 0.43), but increased significantly from 6 months to 12 months (p = 0.002). There was no significant difference between preOP SNP density and SNP density at 12 months in the FECD group. In the mixed model, there was a significant negative association between SNP density and anterior densitometry (p = 0.004), but not with anterior HOA’s (p = 0.63) or total CCT (p = 0.89). Adjusting for age did not affect results. SNP density was lower in the FECD group both preOP (p<0.001) and postOP (p<0.001) when compared to the control group. In the control group, the SNP density was significantly decreased 12 months after surgery (p<0.003).
SNP density is significantly reduced in advanced FECD and does not recover 12 months after DSAEK surgery. There was a significant association between changes in anterior densitometry and changes in SNP nerve density after DSAEK.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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