Ocular surface changes in laser in situ keratomileusis-induced neurotrophic epitheliopathy.
OBJECTIVE
To evaluate the ocular surface changes in patients with laser in situ keratomileusis (LASIK)-induced neurotrophic epitheliopathy.


METHODS
Seven consecutive patients with LASIK-induced neurotrophic epitheliopathy were studied prospectively and compared to a control group (seven consecutive patients who had LASIK- but without neurotrophic epitheliopathy). Bilateral sequential LASIK was performed at a 1-week interval; the first operated eye of each patient was considered for statistical analysis. Blinking, corneal sensitivity, tear break-up time, tear secretion and clearance were measured preoperatively (T0) and postoperatively at 1 week after surgery on the first eye (T1), and 1 week (T2), 1 month (T3), and 3 months (T4) after surgery was performed on the second eye.


RESULTS
Laser in situ keratomileusis-induced neurotrophic epitheliopathy occurred bilaterally in all patients. During follow-up, patients with LASIK-induced neurotrophic epitheliopathy showed a significant decrease in blinking (P = .0002), which was not observed in cases without LASIK-induced neurotrophic epitheliopathy [corrected] Compared to eyes without LASIK-induced neurotrophic epitheliopathy, those with LASIK-induced neurotrophic epitheliopathy revealed lower values of sensitivity in the central cornea preoperatively and early postoperatively (T0, P = .004; T1, P = .003; T2, P = .003). A trend towards reduced sensitivity was also detected in the central cornea in late follow-up and in the superior, temporal, and nasal sectors of the flap at all examinations. No significant differences were observed in break-up time, tear secretion, or clearance within or between the two groups.


CONCLUSIONS
Decreased blinking seems to be involved in the pathogenesis of LASIK-induced neurotrophic epitheliopathy. The reduction probably depends on the lower levels of corneal sensitivity and induces the epitheliopathy by increasing the ocular surface exposure.
Savini
Giacomo
G
Centro Salus, via Saffi 4H, 40131 Bologna, Italy. giacomo.savini@fastwebnet.it
Barboni
Piero
P
Zanini
Maurizio
M
Tseng
Scheffer C G
SC
D000328:Adult; D001082:Aqueous Humor / Q000378:metabolism; D001767:Blinking; D003315:Cornea / Q000294:innervation*; D003316:Corneal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D019573:Epithelium, Corneal / Q000378:metabolism / Q000473:pathology*; D005141:Eyelid Diseases / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D005260:Female; D005456:Fluorescent Dyes; D006801:Humans; D006987:Hypesthesia / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009882:Ophthalmic Nerve / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism
D005456:Fluorescent Dyes