Long-term evaluation of corneal sub-basal nerve recovery after photorefractive keratectomy and influence of pars plana vitrectomy

J Cell Physiol. 2019 May;234(5):7459-7466. doi: 10.1002/jcp.27504. Epub 2018 Nov 11.

Abstract

The corneal sub-basal nerve (SBN) plexus is destroyed during photorefractive keratectomy (PRK) and its recovery is still a matter of debate. In vivo confocal microscopy (IVCM) was used to evaluate SBN plexus in 23 patients at a distance of 10-25 years (mean 15.6 years) from myopic PRK. Because 8 out of the 23 PRK patients underwent pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment, IVCM was also performed on those patients 6 months after PPV. Thirteen patients matched for age and myopia served as controls (non-PRK). SBN plexus was markedly reduced after PRK compared with non-PRK eyes and showed a slow, continuous but incomplete recovery up to the end of our follow-up (range 10-25 years). PRK and non-PRK eyes showed a marked reduction in SBN density 6 months after PPV, thus demonstrating a detrimental effect exerted by PPV on SBN plexus.

Keywords: In vivo confocal microscopy (IVCM); pars plana vitrectomy (PPV); photorefractive keratectomy (PRK); rhegmatogenous retinal detachment (RRD); sub-basal nerve (SBN) plexus.

MeSH terms

  • Cornea / physiology*
  • Cornea / surgery*
  • Epithelium, Corneal / physiology
  • Epithelium, Corneal / surgery
  • Female
  • Humans
  • Male
  • Microscopy, Confocal / methods
  • Middle Aged
  • Myopia / physiopathology*
  • Myopia / surgery*
  • Photorefractive Keratectomy / methods
  • Vitrectomy / methods
  • Wound Healing / physiology