Corneal barrier function, tear film stability, and corneal sensation after photorefractive keratectomy and laser in situ keratomileusis
Section snippets
Patients and methods
We recruited 74 consecutive patients who were undergoing refractive surgery for correction of myopia between July and December 2001. Patients having systemic or ocular diseases such as diabetes mellitus, connective tissue disease, ocular surface disease, corneal disease including anterior basement membrane dystrophy, cataract, glaucoma, and retinal disease were excluded from this study. The research followed the tenets of the Declaration of Helsinki, and informed consent was obtained from all
Results
The number of eyes assessed at each examination point is shown in Table 1. More than 90% of patients were followed up for 1 year. Preoperatively, there was no difference between the PRK and LASIK groups in corneal sensation (Table 2), corneal epithelial permeability (Table 3), tear secretion (Table 4), and tear breakup time (Table 5). The preoperative pachymetry was 537.7 ± 33.8 μm in the PRK group and 542.9 ± 29.0 μm in the LASIK group (P = .843, Wilcoxon rank sum test). The mean laser
Discussion
In PRK, removal of the corneal epithelium and anterior stroma causes damage to the nerve plexus in the superficial cornea. Conversely, injury of the corneal sensory nerve in LASIK occurs at the deeper corneal stroma during the process of creating the lamellar flap. Corneal sensory nerves penetrate the limbus, form thick nerve bundles in the anterior third stroma, then bend 90 degrees, penetrate Bowman’s layer, and form the basal epithelial–subepithelial nerve plexus between the basal epithelial
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