The role of corneal innervation in LASIK-induced neuropathic dry eye.
Almost half the patients who undergo laser in situ keratomileusis (LASIK) experience dry eye following the procedure. However, the etiology of LASIK-induced dry eye is unclear. The purpose of this review is to examine and summarize the current evidence for the etiology of LASIK-induced dry eye, with a focus on ocular surface sensitivity and corneal innervation. Evidence suggests that the alteration of corneal nerves after LASIK is the most likely cause of the subjective symptoms of LASIK-induced dry eye, even though corneal sensitivity and the clinical indicators of dry eye return to apparently normal values within a year due to the partial recovery of the corneal nerve plexus. The hypothesis is explored that dry eye symptoms following LASIK may result from abnormal sensation due to LASIK-induced corneal neuropathy. Other factors, such as alterations in conjunctival goblet cell density, might also contribute to the symptoms and signs of LASIK-induced dry eye. Inter-relationships between nerve morphology, tear neuropeptide levels and dry eye require further investigation. A better understanding of this phenomenon may result in improved management of post-LASIK dry eye.
School of Optometry and Vision Science, University of New South Wales, Sydney, 2052, NSW, Australia. Electronic address: c.chao@unsw.edu.au.
Cecilia
C
Chao
School of Optometry and Vision Science, University of New South Wales, Sydney, 2052, NSW, Australia.
Blanka
B
Golebiowski
School of Optometry and Vision Science, University of New South Wales, Sydney, 2052, NSW, Australia.
Fiona
F
Stapleton
D003315:Cornea / Q000294:innervation* / Q000502:physiology / Q000601:surgery*; D015352:Dry Eye Syndromes / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology
LASIK-induced neuropathic dry eye; corneal nerve morphology; corneal sensitivity; laser in situ keratomileusis; tear function