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 Post subject: Corneal Nerves - Basics and function
PostPosted: Fri Oct 26, 2007 1:33 am 
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Subbasal Nerve Regeneration After LASEK Measured by Confocal Microscopy

Journal of Refractive Surgery Vol. 23 No. 7 September 2007
Taym Darwish, PhD, MSc; Arun Brahma, MD; Nathan Efron, PhD, DSc; Clare O?Donnell, PhD, MCOptom, FAAO

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The cornea is the most densely innervated part of the human body.1 Corneal innervation is supplied by the long ciliary nerves of the ophthalmic division of the trigeminal nerve. Branches of the long ciliary nerve trunk enter the limbus predominantly at the 3 o?clock and 9 o?clock positions, where they lose their myelin sheaths.2 Initially, the branches enter the cornea in the middle third of the stroma. As the branches continue, they move anteriorly and form a subepithelial plexus that densely innervates the central cornea.3 After that, they penetrate Bowman?s membrane and form a terminal intraepithelial plexus.


Quote:
Corneal innervation is essential for the maintenance of corneal structure and function, and provides protective mechanisms against factors that could damage the cornea.1,4 It is also important for tear secretion,5,6 and impaired innervation results in decreased sensitivity and possibly impairment of epithelial and endothelial cell function, decreased cell migration, and cell mitosis.5-7 Moreover, denervated corneas are prone to epithelial or stromal abnormalities, recurrent erosion, impaired wound healing, and infection.1,8 Patients who undergo refractive surgery often complain of dry eye symptoms ranging from mild irritation and foreignbody sensation to pain, photophobia, and decreased visual acuity. These symptoms often are associated with a loss of corneal sensation.3,9

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