| Background and PurposeLaser in situ keratomileusis (LASIK) with its good stability, safety, effectiveand predictable, has become the mainstream of corneal refractive operation, iswidely used in the correction of myopia, hyperopia, astigmatism and presbyopia, etc.But the corneal flap and laser ablation damage the integrity of corneal nerve, thecorneal sensitivity is reduced, the blink response and reduced tear secretion, highincidence of dry eye postoperative, influencing the postoperative visual quality.Therefore, corneal nerve repair is crucial for reliefing dry eye symptoms afteroperation. Corneal nerve belongs to the peripheral nerve,has ability to regenerateafter injury, but a longer time to recover. Studies have shown that recombinantbovine basic fibroblast growth factor (bFGF) can not only promote the cornealepithelium growth, promote the hyperplasia of fibroblasts and collagen fibersarranged regularly, advantageous to repair corneal injury; also can stimulateSchwann cell proliferation and axonal regeneration, promote the repair of peripheralnerve. At present, about bFGF research rarely reported on the role of corneal nerverepair. This study compared with sodium hyaluronate eye drops observation,evaluation of bFGF in LASIK surgery of corneal nerve repair and corneal sensation recovery.MethodsFrom January to July of2013, in our proposed LASIK surgery patients,randomly selected to treatment group (TG) and control group (CG) for clinicalcomparative observation, ruled out after the strict postoperative follow-up observer,TG group20cases (40eyes), CG group include18cases (36eyes).From the firstday, patients of TG group used bFGF eye drops and eye ophthalmic gel, bFGF eyedrops used2times during the day, and bFGF eye ophthalmic gel used once at noonand night before sleep respectively, drip into the conjunctival sac, for threeconsecutive months; patients of CG group used sodium hyaluronate eye drops,4times/d, drip into the conjunctival sac, for three consecutive months,too.All enrolledpatients were examined in uncorrected visual acurity (UCVA), computer optometry,subjective refraction, best corrected visual acuity (BSCVA), corneal topography,intraocular pressure, slit lamp anterior segment examination, A/B ultra ofophthalmology, fundus examination used three sides mirror, corneal sensation,confocal laser microscopy examination in the preoperative and postoperative1week,1month,3months,6months, compared two groups of UCVA, central cornealsubbasal nerve and central corneal perception recovery at each time point after theoperation.ResultsThere were no statistical significance differences of patients’ general databetween treatment group and control group (Pall>0.05). UCVA: Preoperative andpostoperative each point in time,there were no statistically significant differences inboth groups of UCVA (Pall>0.05).At postoperative6months,UCVA of two groupswere greater than or equal to5.0. Central corneal perception: Preoperative andpostoperative1week,1month,3months,6months, the mean central cornealperception of treatment group were59.50±1.53,13.67±5.71,21.67±5.77,31.17±7.51,51.33±4.54, and the control group’s were59.17±1.90,13.50±4.76,19.83±4.64,25.83±11.94,45.83±7.78. There were no differences of corneal perception in bothgroups at preoperative and postoperative1week,1month(P=0.133,0.087,0.094).At the3rd month and6th month postoperative, corneal perception of treatment group was greater than control group’s (P=0.005,0.018), corneal sensitivity oftreatment group close to the preoperative level at the6th month; Central cornealsubepithelial nerve fiber density: the preoperative and postoperative1week,1month,3months,6months,the mean subbasal nerve density of treatment group were(8508.27±2875.23) μm/mm2,(331.07±410.81) μm/mm2,(531.53±516.87) μm/mm2,(1924.73±1160.27) μm/mm2,(4284.07±2372.23) μm/mm2, and the control group’swere (8269.60±2700.97)μm/mm2,(319.53±509.17) μm/mm2,(486.20±611.48)μm/mm2,(952.87±717.92) μm/mm2,(2062.87±2417.16)μm/mm2. There were nodifferences of nerve density between two groups at preoperative and postoperative1week,1month (P=0.260,0.801,0.072),but the nerve density of treatment group washigher than control group’s at the3rd month and6th month(P=0.033,0.000),6months after operation nerve fiber density of two groups were significantly lowerthan the preoperative’s.Conclusions1.The effect of bFGF and Sodium Hyaluronate Eye Drops on UCVA recoveryafter LASIK operation is similar.2. bFGF has a promoting effect on corneal nerve repair and corneal perceptionrecovery in the postoperative of LASIK.3. The application of bFGF with low concentration, small dose for a shortperiod after LASIK is safe and effective. |
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