Corneal Sensation After Cataract and Refractive Surgery

Most surgical procedures involving the anterior segment of the eye disrupt the normal organization of corneal innervation. Since denervation of the cornea results in impaired epithelial wound healing, increased epithelial permeability, decreased epithelial metabolic activity, and loss of cytoskeletal structures associated with cellular adhesion, it is important to identify the factors that determine the extent of neural regeneration. Mechanisms of corneal nerve damage and studies of corneal nerve fiber loss and reinnervation after cataract and refractive surgery--epikeratophakia, cryokeratomileusis, keratomileusis in situ, photorefractive keratectomy, laser in situ keratomileusis, and phacoemulsification--are reviewed and the decrease in corneal sensitivity, as a measure of corneal destruction and corneal metabolism, after these surgical procedures is compared.