May 2006
Volume 47, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2006
Corneal Nerve Morphology and Function After Bladeless and Microkeratome LASIK. A Randomized–Controlled Study
Author Affiliations & Notes
  • J.C. Erie
    Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN
  • S.V. Patel
    Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN
  • J.W. McLaren
    Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN
  • W.M. Bourne
    Ophthalmology, Mayo Clinic College of Medicine, Rochester, MN
  • Footnotes
    Commercial Relationships  J.C. Erie, None; S.V. Patel, None; J.W. McLaren, None; W.M. Bourne, None.
  • Footnotes
    Support  NIH Grant EY02037,Research to Prevent Blindness, and Mayo Foundation
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 516. doi:
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      J.C. Erie, S.V. Patel, J.W. McLaren, W.M. Bourne; Corneal Nerve Morphology and Function After Bladeless and Microkeratome LASIK. A Randomized–Controlled Study . Invest. Ophthalmol. Vis. Sci. 2006;47(13):516.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose:
 

To compare changes in subbasal nerve density and corneal sensitivity in eyes randomized to LASIK performed with a microkeratome or LASIK performed with a femtosecond laser (bladeless).

 
Methods:
 

Twenty patients received LASIK for myopia or myopic astigmatism. One eye of each patient was randomized to flap creation by using a microkeratome (Hansatome, Bausch & Lomb, Rochester, NY) with intended flap thickness of 180 µm, and the fellow eye to flap creation with a femtosecond laser (IntraLase FS, IntraLase Corp., Irvine, CA) with intended flap thickness of 120 µm. Corneas were examined by using confocal microscopy in vivo before and at 1, 3, and 6 months after surgery. Subbasal nerves were measured and nerve density was calculated as the total visible length of nerves per area (µm/mm2). Corneal sensitivity was determined at each visit by using a Belmonte esthesiometer that measured the threshold to mechanical stimulation by a 2–second puff of air (ml/min). Differences between pre– and post–operative nerve densities and corneal sensitivities were compared by using signed–rank tests.

 
Results:
 

Nerve density did not differ between treatments at any time (Table), but was decreased at 1, 3, and 6 months after both treatments (P<0.001) compared to before LASIK. Corneal sensitivity also did not differ between treatments at any time (Table). The mean sensitivity threshold was elevated a nonsignificant 30–31% at 1 month after both treatments compared to preoperative (P>0.14, minimum detectable differences = 29 [microkeratome] and 55 [bladeless], α =0.05, ß=0.20).  

 
Conclusions:
 

Subbasal nerve density is significantly reduced for up to 6 months after LASIK whether the flap is created by using a microkeratome or a femtosecond laser. The anatomical loss of subbasal nerves does not correspond to changes in mechanical corneal sensitivity.

 
Keywords: refractive surgery: LASIK • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • refractive surgery: comparative studies 
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