Ocular surface changes in laser in situ keratomileusis-induced neurotrophic epitheliopathy

Giacomo Savini, Piero Barboni, Maurizio Zanini, Scheffer C G Tseng

Research output: Contribution to journalArticlepeer-review


PURPOSE: To evaluate the ocular surface changes in patients with laser in situ keratomileusis (LASIK) -induced neurotrophic epitheliopathy. METHODS: Seven consecutive patients with LASIK-induced neurotrophic epitheliopathy were studied prospectively and compared to a control group (seven consecutive patients who had LASIK- but without neurotrophic epitheliopathy). Bilateral sequential LASIK was performed at a 1-week interval; the first operated eye of each patient was considered for statistical analysis. Blinking, corneal sensitivity, tear break-up time, tear secretion and clearance were measured preoperatively (T0) and postoperatively at 1 week after surgery on the first eye (T1), and 1 week (T2), 1 month (T 3), and 3 months (T4) after surgery was performed on the second eye. RESULTS: Laser in situ keratomileusis-induced neurotrophic epitheliopathy occurred bilaterally in all patients. During follow-up, patients with LASIK-induced neurotrophic epitheliopathy showed a significant decrease in blinking (P=.0002), which was not observed in cases without LASIK. Compared to eyes without LASIK-induced neurotrophic epitheliopathy, those with LASIK-induced neurotrophic epitheliopathy revealed lower values of sensitivity in the central cornea preoperatively and early postoperatively (T0, P=.004; T 1, P=.003; T2, P=.003). A trend towards reduced sensitivity was also detected in the central cornea in late follow-up and in the superior, temporal, and nasal sectors of the flap at all examinations. No significant differences were observed in break-up time, tear secretion, or clearance within or between the two groups. CONCLUSION: Decreased blinking seems to be involved in the pathogenesis of LASIK-induced neurotrophic epitheliopathy. The reduction probably depends on the lower levels of corneal sensitivity and induces the epitheliopathy by increasing the ocular surface exposure.

Original languageEnglish
Pages (from-to)803-809
Number of pages7
JournalJournal of Refractive Surgery
Issue number6
Publication statusPublished - Nov 2004

ASJC Scopus subject areas

  • Ophthalmology


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