http://www.osnsupersite.com/view.asp?rID=24729

OSN SuperSite Breaking News 11/11/2007

Troutman Award recipient: Post-LASIK corneal neuropathy can mimic dry eye symptoms

NEW ORLEANS — Irregular nerve regeneration after LASIK may cause "phantom pain" that can be mistaken for genuine dry eye symptoms, according to the results of a study presented here.

Ilpo S. Tuisku, MD, FEBO, presented his findings upon accepting the Richard C. Troutman Award during Refractive Subspecialty Day preceding the American Academy of Ophthalmology meeting. The Troutman Award recognizes the work of young authors published in the Journal of Cataract and Refractive Surgery.

Dr. Tuisku attributed neuropathy to aberrant nerve regeneration, which can result from the severing of corneal nerves after flap creation and laser ablation.

"Subjective symptoms of dry eye resemble dry eye," Dr. Tuisku said.

The study group included 20 eyes of 20 patients who underwent LASIK to correct high myopia, defined as 10 D or higher. The control group consisted of 10 eyes of 10 age- and gender-matched subjects, according to the abstract.

Of the study group, 55% reported experiencing more persistent symptoms of ocular discomfort, such as photophobia, irritation and foreign body sensation, than the control group. Also, LASIK patients had a significantly higher ocular surface disease score for dry eye symptoms than those in the control group, according to the study.

The LASIK patients who had postoperative symptoms of dry eye had no appreciable difference in tear production compared to controls, Dr. Tuisku said.

A distinction between dry eyes (the condition) and dry eyes (the symptom) is made in this article. This is hardly news.

The concept of "phantom pain" following LASIK is not particularly earth-shattering either; this has been discussed here frequently over the years. A little logic goes a long way.

Several years ago researchers using confocal microscopy were able to visualize aberrant nerve re-growth into the potential space between the flap and the residual stroma. There have been patients on this site with intractable pain associated with this finding and no significant discussion considering treatment.

What is "new" is that an article discussing the issue of aberrant nerve regrowth has finally received some notoriety. This is analogous to an individual receiving an award posthumously.

What is most unfortunate in any scientific discipline is NOT that researchers fail to have all the answers, it is that researchers fail to ask the obvious questions.

This message has been edited. Last edited by: Dr. DavOD Hartzok,

ptt