{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:24:46Z","timestamp":1791491086128,"version":"4.3.4"},"reference-count":35,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:00:00Z","timestamp":1711324800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82070933"],"award-info":[{"award-number":["82070933"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271046"],"award-info":[{"award-number":["82271046"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Science Technology Department of Zhejiang Province, Zhejiang Key Research and Development Project","award":["2023C03106"],"award-info":[{"award-number":["2023C03106"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2024,2,18]]},"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the bilateral changes in the sub-basal nerve plexus of the cornea and ocular surface function after unilateral small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK) procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>34 patients were enrolled in the study and underwent unilateral SMILE (21 of 34 patients) or unilateral tPRK (13 of 34 patients). Complete ophthalmic examinations, tear film function tests and Cochet-Bonnet esthesiometry were conducted to assess the effects of the surgeries on the corneal nerves and tear function. Morphological changes were assessed using in vivo confocal microscopy to evaluate the corneal sub-basal nerve plexus and dendritic cells. ELISA was used to measure the tear neuromediators. Clinical and morphological data at each follow-up point were compared with preoperative baseline values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients who underwent unilateral SMILE or tPRK procedures exhibited bilateral corneal nerve degenerative changes, decreased corneal sensitivity, worsening of dry eye symptoms and changes in bilateral tear neuromediators. In the SMILE group, bilateral corneal sensitivity was positively correlated with corneal nerve fibre length and negatively correlated with dendritic cell area. The dry eye severity was negatively correlated with corneal sensitivity. Tear levels of substance P and nerve growth factor were positively correlated with mean dendritic cell area and dry eye severity, but negatively correlated with corneal sensitivity. In the tPRK group, bilateral corneal sensitivity was positively correlated with corneal nerve fibre density.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Unilateral refractive surgery may bilaterally affect the morphology and function of corneal nerves and ocular surface status postoperatively.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2023-324358","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T17:27:29Z","timestamp":1711387649000},"page":"1492-1499","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Structural and functional changes of binocular corneal innervation and ocular surface function after unilateral SMILE and tPRK"],"prefix":"10.1136","volume":"108","author":[{"given":"Qianwen","family":"Gong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaiyan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kexin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-6944","authenticated-orcid":false,"given":"Fan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1422-4008","authenticated-orcid":false,"given":"Liang","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,25]]},"reference":[{"key":"2025040502501548000_108.11.1492.1","doi-asserted-by":"crossref","first-page":"6271","DOI":"10.1167\/iovs.16-20242","article-title":"Global patterns in health burden of uncorrected refractive error","volume":"57","author":"Lou","year":"2016","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025040502501548000_108.11.1492.2","first-page":"13","article-title":"Corneal Innervation and sensation: the eye and beyond","volume":"91","author":"Yang","year":"2018","journal-title":"Yale J Biol Med"},{"key":"2025040502501548000_108.11.1492.3","doi-asserted-by":"crossref","first-page":"DES109","DOI":"10.1167\/iovs.17-23538","article-title":"Dry eye after LASIK","volume":"59","author":"Toda","year":"2018","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025040502501548000_108.11.1492.4","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.4103\/1673-5374.308666","article-title":"Corneal neuromediator profiles following laser refractive surgery","volume":"16","author":"Yang","year":"2021","journal-title":"Neural Regen Res"},{"key":"2025040502501548000_108.11.1492.5","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.200"},{"key":"2025040502501548000_108.11.1492.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2016-309142"},{"key":"2025040502501548000_108.11.1492.7","doi-asserted-by":"crossref","first-page":"7179","DOI":"10.1167\/iovs.15-17433","article-title":"Corneal epithelial immune dendritic cell alterations in subtypes of dry eye disease: a pilot in vivo confocal microscopic study","volume":"56","author":"Kheirkhah","year":"2015","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"2025040502501548000_108.11.1492.8","unstructured":"Walker HK . 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