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In vivo confocal microscopy of sub-basal corneal nerves and corneal densitometry after three kinds of refractive procedures for high myopia

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Abstract

Purpose

To observe corneal nerve fibers and densitometry after small incision lenticule extraction (SMILE), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and laser-assisted subepithelial keratomileusis (LASEK) for high myopia.

Methods

This is a prospective, cross-sectional research study. Patients with high myopia (equivalent spherical lens: −6.00 and −11.00D) who underwent laser corneal refractive surgery were divided into three groups: SMILE, FS-LASIK and LASEK. Scheimpflug imaging of corneal nerves in five areas was observed by confocal microscopy before and 6, 12 months after surgery. Corneal densitometry was measured by Pentacam anterior segment analysis system.

Results

Overall, 59 patients were enrolled. The nerve density in the central area did not recover to the preoperative level in three groups until 12 months. The density and length of corneal nerves in central and lower area were better in the SMILE group 6 months postoperatively (p = 0.01), while nerve density did not differ significantly among three groups 12 months postoperatively (p = 0.18). Nerve fibers in central and temporal region were wider in LASEK than that in other two groups at 6- and 12-month follow-up. Corneal densitometry in the central 6 mm diameter was significantly higher in the LASEK group compared with other two groups 6 months postoperatively (p = 0.04). Twelve months postoperatively, corneal densitometry in range of all zone was lower in SMILE than in FS-LASIK and LASEK (p = 0.01, 0.03, 0.04).

Conclusions

Compared with FS-LASIK and LASEK, SMILE-treated eyes with high myopia had certain advantages in nerve density, length and nerve connection way and had better corneal transparency after operation.

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Funding

This study was supported by the Natural Science Foundation of Shandong Province (ZR2019MH115).

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Authors and Affiliations

  1. Department of Ophthalmology, The Affiliated Hospital of Qingdao University, No.16 Jiangsu Road, Qingdao, 266000, Shandong Province, China

    Chenting Hou, Jiangfeng Li, Jinjian Li, Hui Peng & Qing Wang

  2. Affiliated Aier Eye Hospital of Jinan University, Shenzhen, Guangzhou Province, China

    Jiangfeng Li

Authors
  1. Chenting Hou
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  4. Hui Peng
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Contributions

CH searched and filtered literature, analyzed and interpreted data, and was a major contributor in writing the manuscript. JL and JL designed the study and analyzed data. HP participated in charts and figures making. QW revised the article. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Qing Wang.

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Conflict of interest

The authors report no conflicts of interest and have no proprietary interest in any of the materials mentioned in this article.

Ethical approval

This study was adhered to the tenets of the Declaration of Helsinki and was approved by the Ethics Committee of the affiliated hospital of Qingdao University.

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All patients gave informed consent for this research.

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Chenting Hou and Jiangfeng Li are co-first authors.

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Hou, C., Li, J., Li, J. et al. In vivo confocal microscopy of sub-basal corneal nerves and corneal densitometry after three kinds of refractive procedures for high myopia. Int Ophthalmol 43, 925–935 (2023). https://doi.org/10.1007/s10792-022-02494-0

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  • DOI: https://doi.org/10.1007/s10792-022-02494-0

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