Effects of taking pregabalin (Lyrica) on the severity of dry eye, corneal sensitivity and pain after laser epithelial keratomileusis surgery

2020 ◽  
pp. bjophthalmol-2020-317570
Author(s):  
Dong Won Paik ◽  
Dong Hui Lim ◽  
Tae-Young Chung
Keyword(s):  
Nerve Regeneration ◽  
Nerve Fibre ◽  
Dry Eye ◽  
Structural Changes ◽  
Control Group ◽  
Test Results ◽  
Corneal Sensitivity ◽  
Peripheral Neuropathic Pain ◽  
Fibre Density ◽  
Corneal Nerve

BackgroundCorneal nerve damage after laser epithelial keratomileusis (LASEK) is thought to be the cause of dry eye and pain. Therefore, we investigated whether taking pregabalin (Lyrica), which reduces peripheral neuropathic pain, alleviates corneal nerve sensitivity after surgery and reduces dry eye and pain.MethodsPatients were treated with pregabalin (150 mg two times a day for 15 days) from the day before surgery onward and compared with those who did not receive the medications. Before surgery, the severity of dry eye was assessed. Then, corneal sensitivity was assessed by esthesiometry and pain was assessed according to the Visual Analogue Scale. Images of the sub-basal nerve plexus were analysed using confocal microscopy to evaluate nerve regeneration at 6 months.ResultsForty eyes in the pregabalin group and 40 eyes in the control group were included in this study. No significant differences regarding the severity of dry eye, corneal sensitivity test results and nerve fibre density existed between the two groups until 6 months. The pregabalin group showed significantly reduced pain at 1 week.ConclusionsTaking pregabalin during LASEK surgery may affect corneal nerve sensitivity and reduce pain. However, for up to 6 months thereafter, corneal sensitivity and nerve fibre density are not significantly different from findings in the control group, so pregabalin does not seem to affect nerve regeneration or structural changes.

scholarly journals Corneal Nerve Regeneration after Self-Retained Cryopreserved Amniotic Membrane in Dry Eye Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Thomas John ◽  
Sean Tighe ◽  
Hosam Sheha ◽  
Pedram Hamrah ◽  
Zeina M. Salem ◽  
...  
Keyword(s):  
Nerve Regeneration ◽  
Dry Eye ◽  
Amniotic Membrane ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Study Group ◽  
Corneal Sensitivity ◽  
Corneal Nerve

Purpose. To evaluate the efficacy of self-retained cryopreserved amniotic membrane (CAM) in promoting corneal nerve regeneration and improving corneal sensitivity in dry eye disease (DED).Methods. In this prospective randomized clinical trial, subjects with DED were randomized to receive CAM (study group) or conventional maximum treatment (control). Changes in signs and symptoms, corneal sensitivity, topography, and in vivo confocal microscopy (IVCM) were evaluated at baseline, 1 month, and 3 months.Results. Twenty subjects (age 66.9 ± 8.9) were enrolled and 17 completed all follow-up visits. Signs and symptoms were significantly improved in the study group yet remained constant in the control. IVCM showed a significant increase in corneal nerve density in the study group (12,241 ± 5083 μm/mm2at baseline, 16,364 ± 3734 μm/mm2at 1 month, and 18,827 ± 5453 μm/mm2at 3 months,p=0.015) but was unchanged in the control. This improvement was accompanied with a significant increase in corneal sensitivity (3.25 ± 0.6 cm at baseline, 5.2 ± 0.5 cm at 1 month, and 5.6 ± 0.4 cm at 3 months,p<0.001) and corneal topography only in the study group.Conclusions. Self-retained CAM is a promising therapy for corneal nerve regeneration and accelerated recovery of the ocular surface health in patients with DED. The study is registered at clinicaltrials.gov with trial identifier:NCT02764814.

scholarly journals In Vivo Confocal Microscopy Evaluation in Patients with Keratoconus

2022 ◽  
Vol 11 (2) ◽  
pp. 393
Author(s):  
Alvin Wei Jun Teo ◽  
Hassan Mansoor ◽  
Nigel Sim ◽  
Molly Tzu-Yu Lin ◽  
Yu-Chi Liu
Keyword(s):  
Confocal Microscopy ◽  
Nerve Regeneration ◽  
Nerve Fibre ◽  
Ex Vivo ◽  
Fibre Length ◽  
In Vivo Confocal Microscopy ◽  
Corneal Sensitivity ◽  
Mechanical Removal ◽  
Cellular Changes

Keratoconus is the most common primary corneal ectasia characterized by progressive focal thinning. Patients experience increased irregular astigmatism, decreased visual acuity and corneal sensitivity. Corneal collagen crosslinking (CXL), a minimally invasive procedure, is effective in halting disease progression. Historically, keratoconus research was confined to ex vivo settings. In vivo confocal microscopy (IVCM) has been used to examine the corneal microstructure clinically. In this review, we discuss keratoconus cellular changes evaluated by IVCM before and after CXL. Cellular changes before CXL include decreased keratocyte and nerve densities, disorganized subbasal nerves with thickening, increased nerve tortuosity and shortened nerve fibre length. Repopulation of keratocytes occurs up to 1 year post procedure. IVCM also correlates corneal nerve status to functional corneal sensitivity. Immediately after CXL, there is reduced nerve density and keratocyte absence due to mechanical removal of the epithelium and CXL effect. Nerve regeneration begins after 1 month, with nerve fibre densities recovering to pre-operative levels between 6 months to 1 year and remains stable up to 5 years. Nerves remain tortuous and nerve densities are reduced. Corneal sensitivity is reduced immediately postoperatively but recovers with nerve regeneration. Our article provides comprehensive review on the use of IVCM imaging in keratoconus patients.

scholarly journals Patients with multiple sclerosis demonstrate reduced subbasal corneal nerve fibre density

2016 ◽  
Vol 23 (14) ◽  
pp. 1847-1853 ◽  
Author(s):  
Janine Mikolajczak ◽  
Hanna Zimmermann ◽  
Ahmad Kheirkhah ◽  
Ella Maria Kadas ◽  
Timm Oberwahrenbrock ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Dendritic Cells ◽  
Dendritic Cell ◽  
Nerve Fibre ◽  
Disease Severity ◽  
Cell Density ◽  
Clinical Severity ◽  
Fibre Density ◽  
Corneal Nerve

Background: Many studies in multiple sclerosis (MS) have investigated the retina. Little, however, is known about the effect of MS on the cornea, which is innervated by the trigeminal nerve. It is the site of neural-immune interaction with local dendritic cells reacting in response to environmental stimuli. Objective: This study aims to investigate the effect of MS on corneal nerve fibres and dendritic cells in the subbasal nerve plexus using in vivo confocal microscopy (IVCM). Methods: We measured the corneal nerve fibre and dendritic cell density in 26 MS patients and matched healthy controls using a Heidelberg Retina Tomograph with cornea module. Disease severity was assessed with the Multiple Sclerosis Functional Composite, Expanded Disability Status Scale, visual acuity and retinal optical coherence tomography. Results: We observed significant reduction in total corneal nerve fibre density in MS patients compared to controls. Dendritic cell density was similar in both groups. Reduced total nerve fibre density was associated with worse clinical severity but not with previous clinical trigeminal symptoms, retinal neuro-axonal damage, visual acuity or disease duration. Conclusion: Corneal nerve fibre density is a promising new imaging marker for the assessment of disease severity in MS and should be investigated further.

Changes in Langerhans cells and the structure of corneal nerve fibers in patients with glaucoma according in vivo confocal microscopy

2021 ◽  
pp. 30-32
Author(s):  
S.E. Avetisov ◽  
◽  
V.V. Strahov ◽  
Z.V. Surnina ◽  
A.A. Popova ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Confocal Microscopy ◽  
Langerhans Cells ◽  
Structural Changes ◽  
Open Angle Glaucoma ◽  
Anterior Segment ◽  
Nerve Fibers ◽  
Control Group ◽  
Optical Coherence ◽  
Corneal Nerve

The most important tasks of preventing blindness and low vision in primary open-angle glaucoma (POAG) are its early diagnosis and quality monitoring in order to stabilize the glaucoma process. Purpose. To analyze the state of Langerhans inflammatory cells and the structure of corneal nerve fibers in patients with POAG. Material and methods. The study included 46 patients. The main group - 26 patients (52 eyes) aged 39 to 80 years - diagnosed with POAG stages I-IV. Control group - 20 patients (40 eyes) - ophthalmologically healthy volunteers with a normal level of intraocular pressure (IOP) and no signs of POAG at the age from 36 to 72 years. Patients underwent: visometry, biomicroscopy of the anterior segment of the eye, ophthalmoscopy, gonioscopy, contour tonometry using the Pascal method, optical coherence tomography (OCT) of the optic nerve discs (Zeiss Stratus 3000) and confocal microscopy of the cornea (CMR) (HRT III, Rostock Cornea Module). Results. In patients with POAG, according to CMR data, structural changes were revealed in the layer of nerve fibers of the cornea, and abnormalities in the structure and number of inflammatory macrophages (Langerhans cells) were also identified. The interocular asymmetry of CNF was investigated in patients with different stages of glaucoma in paired eyes. Conclusion. Аnalyzing the structure of corneal nerve fibers and Langerhans cells can be used as a diagnostic algorithm in patients with POAG. Key words: glaucoma, confocal microscopy, corneal nerve fibers, Langerhans cells, optical coherence tomography.

scholarly journals Corneal Subbasal Nerve Plexus Changes in Severe Diabetic Charcot Foot Deformity: A Pilot Study in Search for a DNOAP Biomarker

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Anica Herlyn ◽  
Ruby Kala Prakasam ◽  
Sabine Peschel ◽  
Stephan Allgeier ◽  
Bernd Köhler ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Pilot Study ◽  
Nerve Fibre ◽  
Healthy Control Group ◽  
Nerve Plexus ◽  
Control Group ◽  
Healthy Control ◽  
Corneal Nerve ◽  
Subbasal Nerve Plexus

Introduction. Diabetic neuroosteoarthropathy (DNOAP) early symptoms are unspecific, mimicking general infectious symptoms and rendering a diagnosis challenging. Consequently, unfavourable outcomes occur frequently, with recurrent foot ulceration, infectious complications, and eventually amputation. Corneal confocal microscopy (CCM) of the subbasal nerve plexus (SNP) is used to detect early peripheral neuropathy in diabetic patients without diabetic retinopathy. This pilot study was designed to determine if specific SNP changes manifest in severe DNOAP in comparison to a healthy control group. Methods. This pilot study utilized a matched-pair analysis to investigate SNP changes by in vivo CCM for 26 patients (mean patient age 63.7 years, range 27 to 78) with severe DNOAP defined by condition after the need for reconstructive foot surgery (n=13) and a healthy control group (n=13). Corneal nerve fibre length (CNFL), nerve fibre density (CNFD), nerve branch density (CNBD), average weighted corneal nerve fibre thickness (CNFTh), nerve connecting points (CNCP), and average weighted corneal nerve fibre tortuosity (CNFTo) were assessed as well as the general clinical status, diabetic status, and ophthalmologic basic criteria. Results. In vivo CCM revealed significantly reduced SNP parameters in the DNOAP group for CNFL (p=0.010), CNFD (p=0.037), CNBD (p=0.049), and CNCP (p=0.012) when compared to the healthy control group. Six patients (46%) of the DNOAP group suffered from diabetic retinopathy and none of the control group. Conclusions. This pilot study revealed a rarefication of SNP in all measured parameters in patients with severe DNOAP. We see a potential value of CCM providing a SNP-based biomarker for early stages of DNOAP prior to the development of any foot deformities that needs to be evaluated in further studies. This trial is registered with German Clinical Trials Register (DKRS) DRKS00007537.

scholarly journals Corneal Sub-Basal Nerve Changes in Patients with Herpetic Keratitis during Acute Phase and after 6 Months

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 214 ◽  
Author(s):  
Vilija Danileviciene ◽  
Reda Zemaitiene ◽  
Vilte Marija Gintauskiene ◽  
Irena Nedzelskiene ◽  
Dalia Zaliuniene
Keyword(s):  
Risk Factor ◽  
Nerve Fibre ◽  
Previous History ◽  
Eye Disease ◽  
Healthy Controls ◽  
Herpes Labialis ◽  
Corneal Sensitivity ◽  
History Of ◽  
Corneal Nerve ◽  
Branch Density

Background and objectives: The purpose of this study was to describe corneal sensitivity and the morphological changes of sub-basal corneal nerves using in vivo laser scanning confocal microscopy (LSCM) in herpes simplex virus (HSV) keratitis-affected eyes, and to compare with both contralateral eyes and with the eyes of patients with a previous history of herpes labialis but no history of herpetic eye disease, and with healthy patients with no history of any HSV diseases, during the acute phase of the disease and after six months. Materials and Methods: A prospective clinical study included 269 patients. All of them underwent a complete ophthalmological examination, Cochet-Bonnet aesthesiometry and LSCM within the central 5 mm of the cornea. After six months, all the patients with herpetic eye disease underwent the same examination. Serology tests of the serum to detect HSV 1/2 IgG and IgM were performed. Results: HSV-affected eyes compared with contralateral eyes, herpes labialis and healthy control group eyes demonstrated a significant decrease in corneal sensitivity, corneal nerve fibre density, corneal nerve branch density, corneal nerve fibre length and corneal nerve total branch density (p < 0.05). During follow up after six months, corneal sensitivity and sub-basal nerve parameters had increased but did not reach the parameters of contralateral eyes (p < 0.05). Previous herpes labialis did not influence corneal sensitivity and was not a risk factor for herpetic eye disease. Conclusions: Corneal sensitivity and sub-basal nerve changes in HSV-affected eyes revealed a significant decrease compared with contralateral eyes, and with the eyes of patients with a previous history of herpes labialis, and of healthy controls. Following six months, corneal sensitivity and sub-basal nerve parameters increased; however, they did not reach the parameters of contralateral eyes and the eyes of healthy controls. The best recovery of corneal sensitivity was seen in patients with epithelial keratitis. Herpes labialis was not a risk factor for herpetic eye disease.

The effect of nerve growth factor on corneal nerve regeneration and dry eye after LASIK

2021 ◽  
pp. 108428
Author(s):  
Qianwen Gong ◽  
Shasha Zhang ◽  
Lu Jiang ◽  
Meng Lin ◽  
Zhiqiang Xu ◽  
...  
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Nerve Regeneration ◽  
Dry Eye ◽  
Nerve Growth ◽  
Corneal Nerve

scholarly journals Efficacy of rhNGF-loaded amniotic membrane transplantation for rabbit corneal epithelial and nerve regeneration

2021 ◽  
Vol 14 (11) ◽  
pp. 1653-1659
Author(s):  
Lu-Qin Wan ◽  
◽  
Hui-Feng Wang ◽  
Chen Chen ◽  
Hua Li ◽  
...  
Keyword(s):  
Sustained Release ◽  
Nerve Regeneration ◽  
Nerve Fiber ◽  
Amniotic Membrane ◽  
Control Group ◽  
Epithelial Defect ◽  
Corneal Sensitivity ◽  
Corneal Epithelial ◽  
Corneal Epithelial Defect

AIM: To evaluate the efficacy of recombinant human nerve growth factor-loaded amniotic membrane (rhNGF-AM) on corneal epithelial and nerve regeneration in rabbit model. METHODS: Freshly prepared human amniotic membrane (AM) were immersed into PBS buffer containing 100 or 500 μg/mL rhNGF for 15, 30, and 60min at 4℃. The in vitro release kinetics of rhNGF was measured with ELISA. For in vivo evaluation, the AM were immersed with 500 μg/mL rhNGF for 30min. Fifty-seven rabbits were selected to establish corneal epithelial defect model. In addition to the 19 rabbits in control group, 38 rabbits received AM transplantation with or without rhNGF after the removal of central epithelium. Corneal epithelial defect area, sub-epithelial nerve fiber density, corneal sensitivity, rhNGF contents in resident AM and corneas were measured after the surgery. RESULTS: rhNGF was sustained release from the AM within 14d in vitro, with the positive correlation with initial immersion concentration. The immersion of AM in 500 μg/mL rhNGF for 30min achieved the most stable release within 14d. After transplantation in rabbit cornea, a high concentration of rhNGF in resident rhNGF-AM and cornea was maintained within 8d. Corneal epithelial healing, nerve fiber regeneration and the recovery of corneal sensitivity were significantly accelerated after the rhNGF-AM transplantation when compared to simple AM transplantation (all P<0.05). CONCLUSION: Simple immersion of AM achieves the sustained release of rhNGF, and promotes corneal epithelial wound healing and nerve regeneration, as well as the recovery of corneal sensitivity in rabbit.

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