comparison of reinnervation after various methods of corneal surgery

ABSTRACT

Refractive surgical procedures have been associated with a marked postoperative hypaesthesia. Measurement of corneal sensitivity was performed in order to assess the influence of various surgical techniques on postoperative reinnervation. Corneal sensitivity was examined with the Draeger aesthesiometer in eight patients after lamellar keratoplasty, seven patients after epikeratophakia and 82 patients after photorefractive keratectomy. Nine points on each cornea were examined. Corneal sensitivity after lamellar keratoplasty was normal one year after surgery. A correlation with the depth of the lamellar dissection was seen. Patients having lamellar keratoplasty with pterygium showed a decreased sensitivity in the nasal area of the lenticule and the nasal host cornea as much as one year after surgery. Three years after epikeratophakia the central cornea was still unsensitive. After photorefractive keratectomy in eyes with more than 10 D of myopia, a corneal hyposensitivity could be shown as much as two years after surgery. In other words, corneal refractive procedures may lead to a marked delay of reinnervation within the central cornea whatever surgical method is used