Korean J Ophthalmol.  2021 Aug;35(4):255-260. 10.3341/kjo.2021.0048.

Corneal Nerves Alteration Associated with Corneal Complications after Pars Plana Vitrectomy

• Lin T
• Ye H
• Pazo EE
• Dai G
• Xia Y
• He W

• KMID: 2518969
• DOI: http://doi.org/10.3341/kjo.2021.0048

Abstract

Purpose
To evaluate the effect of corneal nerves assessment on predicting corneal complications following pars plana vitrectomy (PPV).
Methods
In this prospective single-center cohort study, 94 patients (94 eyes) received PPV, and were divided into postoperative groups with and without corneal complications. All eyes had corneal nerve fiber length (CNFL), corneal nerve fiber density, and branch density of corneal nerve fibers assessed and calculated with Image J preoperatively. Multivariate logistic regression analysis was used to identify corneal nerve fiber parameters that correlated to post-operative corneal complications. Receiver operator characteristic curve analysis was performed to identify the optimal cut-off point of the corneal fibers’ parameters for predicting corneal complications after PPV.
Results
Eleven eyes (11.70%) developed corneal complications at 1 week after PPV. There was significant difference between CNFL (19.44 ± 6.88 vs. 26.84 ± 7.53, p = 0.003), corneal nerve fiber density (28.82 ± 9.91 vs. 37.10 ± 10.16, p = 0.013) and branch density of corneal nerve fibers (55.84 ± 21.08 vs. 82.04 ± 31.89, p = 0.01) in two groups, respectively. Receiver operator characteristic analysis showed that the optimal cutoff value of CNFL to predict corneal complications following PPV was <26.495 mm/mm².
Conclusions
The decrease of CNFL may predict corneal complications following PPV. Regular preoperative corneal confocal microscopy test in PPV patients could be considered.

Keyword

Microscope; Nerve fibers; Postoperative complications; Vitrectomy