Confocal comparison of corneal nerve regeneration and keratocyte reaction between FS-LASIK, OUP-SBK, and conventional LASIK.
OBJECTIVE
We compared the regeneration characteristics of injured corneal subbasal nerve fibers (CSNFs) and keratocyte reaction following LASIK with a femtosecond laser (FS-LASIK), One Use-Plus Sub-Bowman's keratomileusis (OUP-SBK), and M2 90 microkeratome to provide a more suitable treatment strategy.


METHODS
A total of 22 eyes that underwent FS-LASIK, 32 eyes that underwent OUP-SBK, and 26 eyes that underwent conventional LASIK were analyzed by confocal microscopy. Morphologic modifications of corneal architecture were evaluated postsurgically at 1, 3, and 6 months, and comparisons were made by ANOVA analysis.


RESULTS
The density of stromal keratocytes in the FS-LASIK group was higher than that of OUP-SBK and conventional LASIK groups at 1 month postsurgery (P < 0.05), while in the OUP-SBK group it was higher than that of the FS-LASIK and conventional LASIK groups at 3 months postsurgery (P < 0.05). Regeneration of CSNFs was detected in 90% of eyes in all three groups around 3 mm of the peripheral flap at 1 month postoperation. CSNFs in 6.3% of the eyes in the OUP-SBK group were even observed around the peripheral flap at 6 mm 3 months after surgery, CSNFs were found in 62.5% of eyes (conventional LASIK), 72% of eyes (OUP-SBK), and 64.3% of eyes (FS-LASIK) around 3 mm near the center of the flap. While at 6 months, CSNFs were found in 100% of the eyes in all three groups.


CONCLUSIONS
Keratocyte reactions after FS-LASIK and OUP-SBK were a little more severe than that after conventional LASIK. The repairing velocity of subbasal nerve fibers in the OUP-SBK group was a little faster than that of the FS and conventional LASIK groups.
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China. fjz269@yahoo.com
Fengju
F
Zhang
Shijing
S
Deng
Ning
N
Guo
Mengmeng
M
Wang
Xuguang
X
Sun
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D003315:Cornea / Q000294:innervation*; D060527:Corneal Keratocytes / Q000502:physiology*; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009416:Nerve Regeneration / Q000502:physiology*; D011182:Postoperative Care; D011446:Prospective Studies; D055815:Young Adult