Abstract

SO.19.07

Correlation of corneal sensation and regeneration of subepithelal nerve plexus after fs-LASIK

Andrey Zhivov1, Oliver Stachs1, Marcus Blum2, Wilfried Bissmann3, Rudolf Guthoff1
1Universitäts-Augenklinik Rostock, 2Augenklinik, Helios-Klinikum, Erfurt, 3Carl Zeiss Meditec AG, Jena

Objective
Femtosecond technology enables to create a tissue friendly flap by LASIK. The aim of the paper is to compare the regeneration of subepithelial nerve plexus (SEP) and corneal sensation after 2 different femtosecond - methods. 
Methods
18 eyes from 9 Patients aged 17-43 were investigated with Heidelberg Retina Tomograph (HRT II) in combination with Rostock Cornea Module 1 week, 1 month and 3 months after the fs-LASIK. The operation was performed both sides: one eye undergone FLEx-Method (Femtosecond Lenticule Extraction) with hinge overhead (90º). The other eye was operated with 2 fs-incisions each 90º on the temporal and nasal side. Confocal microscopy of SEP was  performed in center of flap, on flap edge (temporal, at the bottom and nasal) as well as in the hinge area in FLEx group and on flap edge (temporal and nasal) as well as in the intact area overhead and at the bottom in the second group (SMILE method). An off-line 2D-Mapping of SEP was performed. Corneal sensation was followed up with Cochet-Bonnet esthesiometer.
Results
In vivo confocal microscopy with following off-line reconstruction allows mapping up to 2x2 mm.  Moreover, the reconstruction of the flap edge is possible.  The SEP brunches of hinge area run up to corneal center after FLEx. SMILE method is characterized by intact structure of SEP in center, the SEP brunches run non-stop in vertical direction. The first regenerated over the flap edge brunches were noted after one month. The regeneration of SEP correlates with esthesiometer findings, although there were no significant changes in corneal sensation between these 2 fs-LASIK procedures. The qualitative analysis of SEP showed a better regeneration of SEP in SMILE-Group
Conclusions
Corneal sensation correlates with regeneration of SEP after fs-LASIK. Although no significant changes in corneal sensation were found, SMILE method showed a better regeneration of SEP

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