August 22, 2014
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PRK with cross-linking markedly reduces keratocyte, nerve density

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PRK combined with corneal collagen cross-linking had a transient effect on corneal innervation and a significant effect on keratocyte density for up to 4 years postoperatively, researchers found.

The researchers prospectively analyzed 17 eyes of 17 patients with progressive keratoconus who underwent PRK with corneal collagen cross-linking. Confocal microscopy was used preoperatively and 1, 3, 6, 12, 18 and 48 months postoperatively to assess corneal morphology. Primary study outcome measures were mean superficial epithelial cell density, mean basal epithelial cell density and mean anterior and mid/posterior keratocyte density. Stromal backscatter, sub-basal and stromal nerve density, and mean endothelial cell density were also evaluated.

Mean superficial epithelial cell density, mean basal epithelial cell density and mean endothelial cell density were unchanged from baseline to 4-year follow-up.

Anterior mid-stromal keratocyte density decreased significantly from baseline, whereas mean posterior keratocyte density increased significantly at 1 and 3 months but was unchanged at 6, 12, 18 and 48 months, according to the researchers.

Significant decreases in sub-basal and stromal nerve density were seen until month 6; these densities returned to preoperative values by month 18.

Mean total length of nerves, mean total length of nerves per image, mean total number of sub-basal nerves and mean total number of stromal nerves returned to preoperative values at 4 years, according to the authors.

Disclosure: The authors have no relevant financial disclosures.