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State of corneal nerve fibers after phacosurgery

The question of potential changes in CNF induced by phacosurgery remains poorly understood. The need for research in this direction is dictated by a number of circumstances: the introduction into clinical practice of confocal microscopy of the cornea, the need for phacosurgery against the background of changes in the cornea of various genesis, the possibility of the negative impact of laser radiation in the process of hybrid (femtolaser) phacoemulsification. Purpose. Assessment of changes in CNF after various methods of microinvasive phacosurgery. Material and methods. The studies were conducted in two groups of patients aged 50 to 60 years who underwent standard ultrasound and hybrid PV (30 operations each, respectively). The algorithm for assessing the state of the nerve fibers of the cornea included laser confocal microscopy using original software. To quantify the state of nerves, two coefficients were used: directivity anisotropy (K Δ L) and directivity symmetry (Ksym). Results. Regardless of the operation methodology, a tendency toward a decrease in the directivity anisotropy coefficient and an increase in the directivity symmetry coefficient, conditionally comparable with previously identified age-related changes in nerve fibers, was noted. After hybrid phacoemulsification, a decrease in the directivity anisotropy coefficient 2–2.5 months after the intervention turned out to be statistically less significant compared to the standard ultrasound technique. Further research should be aimed at analyzing the long-term results of both microinvasive phacosurgery techniques and the “classical” extracapsular cataract extraction, which still remains the method of choice in a number of clinical situations. Key words: corneal nerve fibers, phacosurgery, in vivo laser microscopy.