Abstract
Purpose To evaluate changes in corneal sensitivity and subbasal nerve density after pterygium excision. Methods This prospective trial included 22 eyes with nasal primary pterygium and 18 controls. Corneal sensitivity was evaluated using a Cochet–Bonnet esthesiometer in the nasal, superior, temporal, inferior, and center quadrants of the cornea before surgery and 10 days, 1 month, and 3months after surgery. The central cornea was analyzed using in vivo confocal microscopy (IVCM) before surgery and 1 and 3 months after surgery. Subbasal nerve density and other nerve parameters were analyzed using NeuronJ. Nerve tortuosity was evaluated and graded in individual IVCM scans. The tear film break-up time (TBUT) test and Schirmer's test were performed before surgery, as well as 1 and 3 months after surgery. All the same tests were performed in the controls. Results All affected eyes showed a significant increase in corneal sensitivity in the nasal corneal quadrant after surgery when compared with preoperative data (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (F = 37.3; P < 0.01). Compared with controls, pterygium patients demonstrated decreased corneal subbasal nerve density (Conclusion Pterygium patients demonstrated deteriorated corneal subbasal nerve fibers when compared with healthy controls in terms of nerve length, nerve trunks, and nerve branches. Therefore, pterygium excision improves corneal sensitivity and increases corneal subbasal nerve density.
Highlights
Pterygium is a wing-shaped fibrovascular growth from the bulbar conjunctiva extending toward the cornea
Our study found deteriorated corneal subbasal nerve fibers and unstable tear film in patients with pterygium when compared with healthy eyes
We observed increased central subbasal nerve density along with better corneal sensitivity 1 month and 3 months after pterygium excision. is suggests that the functional sensitivity changes are related to anatomical corneal nerve changes in those patients
Summary
Pterygium is a wing-shaped fibrovascular growth from the bulbar conjunctiva extending toward the cornea. Hypoesthesia has been reported in the nasal corneas of patients with pterygium [15, 16] In this regard, Journal of Ophthalmology corneal sensitivity is a measure of corneal nerve function and indicates the integrity of the protective mechanisms of the ocular surface. Two studies showed that both epithelial membrane and Bowman’s membrane are altered in the affected corneas in pterygium patients whose nerve plexus could not be detected using in vivo laser scanning confocal microscopy [23, 24]. Corneal sensitivity was measured using the Cochet–Bonnet esthesiometer (Luneau Ophthalmlogie, Chartres, France) before surgery as well as 10 days, 1 month, and 3 months after surgery in both patients and healthy controls. Data were expressed as mean ± standard error of the mean
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