title: Decreased Corneal Sensation and Subbasal Nerve Density, and Thinned Corneal Epithelium as a Result of 360-Degree Laser Retinopexy.
abstract: OBJECTIVE
  To assess the effects of 360-degree laser retinopexy on human corneal subbasal nerve plexus and to investigate correlations among corneal subbasal nerve plexus density, corneal epithelial thickness, and corneal sensitivity.
  
  
  METHODS
  Prospective, observational, nonrandomized study.
  
  
  METHODS
  A total of 15 eyes of 15 patients who underwent pars plana vitrectomy (PPV) with 360-degree laser retinopexy for retinal detachment (RD) and 15 eyes of 15 patients who underwent PPV for macular hole (MH) without laser treatment.
  
  
  METHODS
  Corneal sensation, corneal epithelial thickness, and corneal subbasal nerve plexus density were assessed before surgery and 6 months after surgery via in vivo confocal microscopy, anterior segment optical coherence tomography (AS-OCT), and Cochet-Bonnet esthesiometry (Luneau Ophthalmologie, Paris, France).
  
  
  METHODS
  Corneal subbasal nerve plexus density, corneal epithelium thickness, and central corneal sensitivity.
  
  
  RESULTS
  Compared with baselines values, the mean subbasal nerve density (P < 0.001), mean corneal epithelium thickness (P = 0.006), and mean corneal sensitivity (P < 0.001) in the RD group were significantly decreased 6 months after surgery by 74.3%, 4.7%, and 56.6%, respectively. Conversely, in the MH group there were no significant differences in the mean subbasal nerve density (P = 0.34), mean corneal epithelial thickness (P = 0.19), and mean corneal sensitivity (P = 0.42) between preoperative and 6-month postoperative values (0.7%, 0.4%, and 0.8%, respectively). The postoperative decrease in corneal subbasal nerve density after laser retinopexy was associated with a decrease in corneal epithelium thickness (r(2) = 0.42; P = 0.006) and a decrease in corneal sensitivity (r(2) = 0.48; P = 0.004). The postoperative decrease in corneal sensitivity poorly correlated with the decrease in corneal epithelial thickness (r(2) = 0.24; P = 0.045). Postoperative corneal nerve density decreased as total laser energy increased (r(2) = 0.51; P = 0.002).
  
  
  CONCLUSIONS
  Subbasal corneal nerve plexus density decreases after 360-degree laser retinopexy and is accompanied by epithelium thinning and decreased corneal sensation. Surgeons should eschew heavy confluent retinal laser treatment, and corneal sensitivity should be assessed postoperatively to determine whether significant anesthesia has occurred. In such instances, prophylactic measures may be warranted against the development of neurotrophic ulcers.
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France; INSERM UMR S 968, Institut de la Vision, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS, UMR 7210, Paris, France. Electronic address: nacim.bouheraoua@gmail.com.
authors.forename: Nacim
authors.initials: N
authors.lastname: Bouheraoua
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Linda
authors.initials: L
authors.lastname: Hrarat
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Cameron F
authors.initials: CF
authors.lastname: Parsa
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Jad
authors.initials: J
authors.lastname: Akesbi
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Otman
authors.initials: O
authors.lastname: Sandali
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Goemaere
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France.
authors.forename: Taous
authors.initials: T
authors.lastname: Hamiche
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France; INSERM UMR S 968, Institut de la Vision, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS, UMR 7210, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Laroche
authors.affiliation: Quinze-Vingts National Ophthalmology Hospital, UPMC-Sorbonne Universities, Paris, France; INSERM UMR S 968, Institut de la Vision, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR S 968, Institut de la Vision, Paris, France; CNRS, UMR 7210, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Borderie
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000294:innervation* / Q000503:physiopathology*; D017679:Cryotherapy / Q000009:adverse effects*; D058450:Endotamponade; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D053685:Laser Therapy / Q000379:methods; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D011446:Prospective Studies; D012163:Retinal Detachment / Q000601:surgery; D012167:Retinal Perforations / Q000601:surgery; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D020433:Trigeminal Nerve Diseases / Q000209:etiology / Q000503:physiopathology*; D014821:Vitrectomy
chemical_list: D005466:Fluorocarbons; C048381:perfluoroethane; D013459:Sulfur Hexafluoride