Evaluation of corneal sensitivity to mechanical and chemical stimuli after LASIK: a pilot study.
OBJECTIVE
To evaluate the effect of laser in situ keratomileusis (LASIK) on corneal sensitivity, nerve morphology, and tear film characteristics.


METHODS
A cross-sectional study design was used. Eighteen patients (eight men and 10 women with a mean age of 36.9 +/- 11.2 years) who had undergone bilateral LASIK for low myopia within 18 months of the study and 28 control subjects (16 men and 12 women with a mean age of 27.2 +/- 7.7 years) were enrolled. Central and inferior corneal thresholds to mechanical (air) and chemical (air plus carbon dioxide) stimuli were determined by using a staircase technique. Stimuli of a 1-second duration at 34 degrees C were delivered with a CRCERT-Belmonte aesthesiometer. Images of subbasal nerves in the central cornea were captured with confocal microscopy. Nerve morphology was classified as no nerves, short nerves (<175 microm), or long nerves (>175 microm), with or without interconnections. Noninvasive tear break up time was measured. The phenol red thread test was used to indicate basal tear secretion. Differences between groups were evaluated with analysis of variance, and associations between variables were evaluated with parametric or nonparametric correlation, when appropriate.


RESULTS
Central corneal mechanical sensitivity was significantly reduced in the post-LASIK group compared with the control subjects (P < 0.001). Nerve morphology was associated with mechanical threshold. Nerve morphology, mechanical sensitivity, and tear breakup time improved during the first 1 to 3 months after surgery, with little change thereafter. Chemical sensitivity was associated with tear secretion (P < 0.05).


CONCLUSIONS
Central corneal mechanical sensitivity is reduced in patients after LASIK, with partial recovery seen 3 months after surgery. A similar recovery trend is seen for nerve morphology.
Cornea and Contact Lens Research Unit, School of Optometry and Vision Science and Vision Cooperative Research Centre, University of New South Wales, Sydney, Australia. f.stapleton@unsw.edu.au
Fiona
F
Stapleton
Karen B
KB
Hayward
Nicci
N
Bachand
Phung H
PH
Trong
Daniel W H
DW
Teh
Karen M Y
KM
Deng
Eleanor I H
EI
Yang
Simon L
SL
Kelly
Monica
M
Lette
David
D
Robinson
D000328:Adult; D000388:Air; D002245:Carbon Dioxide; D003315:Cornea / Q000294:innervation / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006987:Hypesthesia / Q000209:etiology* / Q000503:physiopathology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D008297:Male; D009216:Myopia / Q000601:surgery; D009412:Nerve Fibers / Q000502:physiology; D009882:Ophthalmic Nerve / Q000033:anatomy & histology / Q000502:physiology*; D010812:Physical Stimulation; D010865:Pilot Projects; D013268:Stimulation, Chemical; D013524:Surgical Flaps; D013666:Tears / Q000378:metabolism*
D002245:Carbon Dioxide