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Yu-Chi Liu, Molly Tzu-Yu Lin, Jodhbir S Mehta; Tear Neuromediator and Corneal Denervation following Small Incision Lenticule Extraction (SMILE). Invest. Ophthalmol. Vis. Sci. 2021;62(8):956.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the changes in tear neuromediators and corneal subbasal nerve plexus following small incision lenticule extraction (SMILE).
Thirty patients were included for tear neuromediator analysis (40 eyes) and corneal nerve analysis using in-vivo confocal microscopy scans (20 eyes). Tear analysis included substance P (SP), calcitonin gene-related peptide (CGRP) and nerve growth factor (NGF) concentrations.
Corneal nerve fiber density (CNFD), corneal nerve fiber length (CNFL), and corneal nerve branch density (CNBD) decreased significantly postoperatively, then gradually increased from 3 months onward, but did not recover to the baseline levels at 12 months. Tear SP and CGRP levels remained stable over 12 months. Tear NGF levels demonstrated a small peak at 1 week, before decreasing significantly compared to preoperative levels at 6 months (P=0.03) and 12 months (P<0.01). The 1-month reduction in CNFL, tear SP and CGRP concentrations were significantly correlated with the spherical equivalent (SE) corrected (r= 0.71 for CNFL; r= -0.33 ~ -0.52 at different time points for SP and CGRP, respectively, all P<0.05). The high myopia group (corrected SE greater than -6.0 diopters), compared to the low-moderate myopia group, had significantly greater decrease in CNFD, and significantly higher tear SP concentrations at 1 week, 1 month and 6 months, as well as significantly higher tear CGRP concentrations at 1 and 6 months.
Our results provide new insight into the neuro-biological responses and their potential implications in corneal nerve damage and recovery after SMILE. High myopic treatment was associated with greater corneal denervation and neuroinflammation.
This is a 2021 ARVO Annual Meeting abstract.
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