Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 9/2005

01.09.2005 | Clinical Investigation

Tear film function and corneal sensation in the early postoperative period after LASEK for the correction of myopia

verfasst von: Wolfgang Artur Herrmann, Chirag Pradip Shah, Christoph Winkler von Mohrenfels, Bernhard Gabler, Karsten Hufendiek, Chris Patrick Lohmann

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 9/2005

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Subepithelial nerves and stromal nerves of the cornea are damaged during LASEK surgery for the correction of myopia. This leads to a reduction in corneal sensation and to alterations of the tear film function in the early postoperative period. The aim of this study was to evaluate tear film function, corneal sensation and subjective symptoms of dry eye in the early postoperative period after LASEK for the correction of myopia.

Methods

LASEK surgery was performed in 20 eyes of 10 consecutive patients for the correction of myopia (−1.0 to −9.0 D, mean −4.86 D). Subjective symptoms of a dry eye were evaluated with a standardised questionnaire. Schirmer test with and without local anaesthesia, tear film break-up time, fluorescein staining of the cornea and corneal esthesiometry (Cochet–Bonnet) were performed before surgery and 1 week, 1 month, 2 months and 3 months after LASEK. Additionally corneal staining and subjective symptom severity scores were assessed 3 days after surgery.

Results

Corneal sensation was reduced 1 week after LASEK and recovered during the first month after LASEK. The tear film break-up time was reduced 1 week and 1 month after LASEK and reached preoperative values 2 months after surgery. Fluorescein staining was increased 3 days and 1 week after LASEK. Subjective symptom severity scores were increased 3 days, 1 week, 1 month and 2 months after LASEK. Schirmer tests values with local anaesthesia were significantly reduced at 3 months after surgery, but not at 3 days, 1 month, or 2 months. Schirmer test values without local anaesthesia were significantly decreased 2 and 3 months after LASEK, but not after 3 days and 1 month after LASEK.

Conclusions

LASEK alters ocular surface haemostasis and reduces corneal sensation in the early postoperative period. Subjective symptoms of dry eye were described during the first 2 months after surgery.
Literatur
1.
Zurück zum Zitat Afonso AA, Monroy D, Stern ME, Feuer WJ, Tseng SC, Pflugfelder S (1999) Correlation of tear fluorescein clearance and Schirmer test scores with ocular irritation symptoms. Ophthalmology 106:803–810 Afonso AA, Monroy D, Stern ME, Feuer WJ, Tseng SC, Pflugfelder S (1999) Correlation of tear fluorescein clearance and Schirmer test scores with ocular irritation symptoms. Ophthalmology 106:803–810
2.
Zurück zum Zitat Battat L, Macri A, Dursun D, Pflugfelder S (2001). Effects of laser in situ keratomileusis on tear production, clearance and the ocular surface. Ophthalmology 108:1230–1235 Battat L, Macri A, Dursun D, Pflugfelder S (2001). Effects of laser in situ keratomileusis on tear production, clearance and the ocular surface. Ophthalmology 108:1230–1235
3.
Zurück zum Zitat Benitez-del-Castillo JM, del Rio T, Iradier T, Hernandez JL, Castello A, Garcia-Sanchez J (2001) Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea 20:30–32 Benitez-del-Castillo JM, del Rio T, Iradier T, Hernandez JL, Castello A, Garcia-Sanchez J (2001) Decrease in tear secretion and corneal sensitivity after laser in situ keratomileusis. Cornea 20:30–32
4.
Zurück zum Zitat Camellin M (1999) LASEK may offer the advantages of both LASIK and PRK. Ocular Surg News Int Ed 3:14–15 Camellin M (1999) LASEK may offer the advantages of both LASIK and PRK. Ocular Surg News Int Ed 3:14–15
5.
Zurück zum Zitat Herrmann W, Shah C, Gabler B, Winkler von Mohrenfels C, Hufendiek C, Lohmann C (2005) Corneal sensation after LASEK for the correction of myopia. Graefes Arch Clin Exp Ophthalmol 243(1):33–37 Herrmann W, Shah C, Gabler B, Winkler von Mohrenfels C, Hufendiek C, Lohmann C (2005) Corneal sensation after LASEK for the correction of myopia. Graefes Arch Clin Exp Ophthalmol 243(1):33–37
6.
Zurück zum Zitat Kaufmann HE, Barron B, McDonald MB (1998) Corneal innervation. In: Kaufmann HE, Barron B, McDonald MB (eds) The cornea, 2nd edn. Butterworth and Heinemann, Boston pp 23–26 Kaufmann HE, Barron B, McDonald MB (1998) Corneal innervation. In: Kaufmann HE, Barron B, McDonald MB (eds) The cornea, 2nd edn. Butterworth and Heinemann, Boston pp 23–26
7.
Zurück zum Zitat Linna TU, Perez-Santonja JJ, Tervo KM, Sakla HF, Alio JL, Tervo TMT (1998) Recovery of corneal nerve morphology following laser in situ keratomileusis. Exp Eye Res 66:755–763 Linna TU, Perez-Santonja JJ, Tervo KM, Sakla HF, Alio JL, Tervo TMT (1998) Recovery of corneal nerve morphology following laser in situ keratomileusis. Exp Eye Res 66:755–763
8.
Zurück zum Zitat Lohmann CP, Winkler von Mohrenfels C, Gabler B, Herrmann W, Müller M (2002) Excimer Laser Subepitheliale Ablation (ELSA) bzw. Laser Subepitheliale Keratomileusis (LASEK)–Ein neuartiges refraktiv- chirurgisches Verfahren zur Myopiekorrektur. Operationstechnik und erste klinsche Ergebnisse an 24 Augen und nach 3 Monaten. Klin Monatsbl Augenheilkd 219:26–32 Lohmann CP, Winkler von Mohrenfels C, Gabler B, Herrmann W, Müller M (2002) Excimer Laser Subepitheliale Ablation (ELSA) bzw. Laser Subepitheliale Keratomileusis (LASEK)–Ein neuartiges refraktiv- chirurgisches Verfahren zur Myopiekorrektur. Operationstechnik und erste klinsche Ergebnisse an 24 Augen und nach 3 Monaten. Klin Monatsbl Augenheilkd 219:26–32
9.
Zurück zum Zitat Matsui H, Kumano Y, Zushi I, Yamada T, Matsui T, Nshida T (2001) Corneal sensation after correction of myopia by photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg 27:370–373 Matsui H, Kumano Y, Zushi I, Yamada T, Matsui T, Nshida T (2001) Corneal sensation after correction of myopia by photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg 27:370–373
10.
Zurück zum Zitat Muller LJ, Vrensen GF, Pels L, Cardozo BN, Willekens B (1997) Architecture of human corneal nerves. Invest Ophthalmol Vis Sci 38:985–994 Muller LJ, Vrensen GF, Pels L, Cardozo BN, Willekens B (1997) Architecture of human corneal nerves. Invest Ophthalmol Vis Sci 38:985–994
11.
Zurück zum Zitat Ozdamar A, Acras C, Karakas N, Sener B, Karacorlu M (1999). Changes in tear flow and tear film stability after photorefractive keratectomy. Cornea 18:437–439 Ozdamar A, Acras C, Karakas N, Sener B, Karacorlu M (1999). Changes in tear flow and tear film stability after photorefractive keratectomy. Cornea 18:437–439
12.
Zurück zum Zitat Perez-Santonja J, Sakla H, Cardona C, Chipont E, Alio J (1999) Corneal sensitivity after photorefractive keratectomy and laser in situ keratomileusis for low myopia. Am J Ophthalmol 127:497–504 Perez-Santonja J, Sakla H, Cardona C, Chipont E, Alio J (1999) Corneal sensitivity after photorefractive keratectomy and laser in situ keratomileusis for low myopia. Am J Ophthalmol 127:497–504
13.
Zurück zum Zitat Siganos DS, Popescu CN, Siganos CS, Pistola G (2000) Tear secretion following spherical and astigmatic excimer laser photorefractive keratectomy. J Cataract Refract Surg 26:1585–1589 Siganos DS, Popescu CN, Siganos CS, Pistola G (2000) Tear secretion following spherical and astigmatic excimer laser photorefractive keratectomy. J Cataract Refract Surg 26:1585–1589
14.
Zurück zum Zitat Stern ME, Beuerman RW, Fox RI et al (1998) The pathology of dry eye: the interaction between the ocular surface and lacrimal glands (review). Cornea 17:584–589 Stern ME, Beuerman RW, Fox RI et al (1998) The pathology of dry eye: the interaction between the ocular surface and lacrimal glands (review). Cornea 17:584–589
15.
Zurück zum Zitat Tilch D, Selbach JM, Laube T, Theiss C, Steuhl KP, Meller D (2003) Corneal substance-P-ergic innervation after laser epithelial keratomileusis (LASEK) in comparison to photorefractive keratectomy (PRK) in rabbits. Invest Ophthalmol Vis Sci: e-abstract 2682 Tilch D, Selbach JM, Laube T, Theiss C, Steuhl KP, Meller D (2003) Corneal substance-P-ergic innervation after laser epithelial keratomileusis (LASEK) in comparison to photorefractive keratectomy (PRK) in rabbits. Invest Ophthalmol Vis Sci: e-abstract 2682
16.
Zurück zum Zitat Toda I, Asano-Kato N, Komai-HoriY, Tsubota K (2001) Dry eye after laser in situ keratomileusis. Am J Ophthalmol 132:1–7 Toda I, Asano-Kato N, Komai-HoriY, Tsubota K (2001) Dry eye after laser in situ keratomileusis. Am J Ophthalmol 132:1–7
17.
Zurück zum Zitat Watkins LR, Wiertelak EP, Goehler LE, Smith KP, Martin D, Maier SF (1994) Characterization of cytokine-induced hyperalgesia. Brain Res 654:15–26 Watkins LR, Wiertelak EP, Goehler LE, Smith KP, Martin D, Maier SF (1994) Characterization of cytokine-induced hyperalgesia. Brain Res 654:15–26
18.
Zurück zum Zitat Wilson SE (2001) Laser in situ keratomileusis-induced (presumed) neurotrophic epitheliopathy. Ophthalmology 108:1082–1087 Wilson SE (2001) Laser in situ keratomileusis-induced (presumed) neurotrophic epitheliopathy. Ophthalmology 108:1082–1087
19.
Zurück zum Zitat Yu EY, Leung A,, Rao S, Lam DSC (2000) Effect of laser in situ keratomileusis on tear stability. Ophthalmology 107:2131–2135 Yu EY, Leung A,, Rao S, Lam DSC (2000) Effect of laser in situ keratomileusis on tear stability. Ophthalmology 107:2131–2135
Metadaten
Titel
Tear film function and corneal sensation in the early postoperative period after LASEK for the correction of myopia
verfasst von
Wolfgang Artur Herrmann
Chirag Pradip Shah
Christoph Winkler von Mohrenfels
Bernhard Gabler
Karsten Hufendiek
Chris Patrick Lohmann
Publikationsdatum
01.09.2005
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 9/2005
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-005-1130-0

Weitere Artikel der Ausgabe 9/2005

Graefe's Archive for Clinical and Experimental Ophthalmology 9/2005 Zur Ausgabe

Announcements

September 2005

Neu im Fachgebiet Augenheilkunde

Metastase in der periokulären Region

Metastasen Leitthema

Orbitale und periokuläre metastatische Tumoren galten früher als sehr selten. Aber mit der ständigen Aktualisierung von Medikamenten und Nachweismethoden für die Krebsbehandlung werden neue Chemotherapien und Strahlenbehandlungen eingesetzt. Die …

Staging und Systemtherapie bei okulären und periokulären Metastasen

Metastasen Leitthema

Metastasen bösartiger Erkrankungen sind die häufigsten Tumoren, die im Auge diagnostiziert werden. Sie treten bei ungefähr 5–10 % der Patienten mit soliden Tumoren im Verlauf der Erkrankung auf. Besonders häufig sind diese beim Mammakarzinom und …

Wundheilung nach Trabekulektomie

Trabekulektomie CME-Artikel

Die überschießende Wundheilung in der filtrierenden Glaukomchirurgie ist ein zentraler Faktor für ein operatives Versagen. Nach der Einführung der Trabekulektomie in den 1960er-Jahren wurden viele Faktoren erkannt, die mit einer vermehrten …

„standard operating procedures“ (SOP) – Vorschlag zum therapeutischen Management bei periokulären sowie intraokulären Metastasen

Metastasen Leitthema

Peri- sowie intraokuläre Metastasen sind insgesamt gesehen selten und meist Zeichen einer fortgeschrittenen primären Tumorerkrankung. Die Therapie ist daher zumeist palliativ und selten kurativ. Zudem ist die Therapiefindung sehr individuell. Die …

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.