Contact lens & anterior eye : the journal of the British Contact Lens Association · 2026
Morphological alterations of corneal nerve after short-term scleral lens therapy for severe dry eye: an in vivo confocal microscopic study.
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Chen Xiaohan, Lu Chuwei, Zhou Xueyi, Tian Lijia, Zeng Li, Zhou Xingtao, Hong Jiaxu, Chen Zhi, Le Qihua
Аннотация
PURPOSE: To evaluate the morphological alterations of corneal subbasal nerve plexus after short-term scleral lens (SL) therapy in severe dry eye (DE) patients with the application of in vivo confocal microscopy (IVCM).
METHODS: This single-center prospective cohort study enrolled 20 eyes of 20 severe DE patients. Apart from the collection of DE symptoms and clinical signs, IVCM was performed before and after one-month SL therapy, and the parameters of subbasal nerve plexus were analyzed including corneal nerve fibre length (CNFL), corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), and tortuosity coefficient (TC). Moreover, correlation analysis was performed to explore the relationship between the alterations of DE and nerve parameters.
RESULTS: The symptoms and signs of DE were significantly improved after one-month SL therapy. The score of Ocular Surface Disease Index (OSDI) and corneal fluorescein staining (CFS) score decreased from 57.28 (2.780-100.0) and 13.1 ± 2.4 to 8.86 (0-50) and 8 (0-15), respectively, while fluorescein tear break-up time (FBUT) increased from (0.4 ± 0.5) s to (2.2 ± 2.0) s (all p < 0.001). Moreover, CNFL and CNFD were considerably increased after one-month SL therapy (all p < 0.05). The correlation analysis revealed that the first and average non-invasive breakup times (f-NIBUT, a-NIBUT) negatively correlated with CNBD (both p < 0.05).
CONCLUSIONS: One-month SL therapy may not only alleviate the symptoms and signs of severe DE, but also improve the morphology of corneal subbasal nerve plexus. SL therapy has great potential in the management of ocular discomfort symptoms and refractory ocular pain associated with corneal nerve abnormalities in severe DE patients.
METHODS: This single-center prospective cohort study enrolled 20 eyes of 20 severe DE patients. Apart from the collection of DE symptoms and clinical signs, IVCM was performed before and after one-month SL therapy, and the parameters of subbasal nerve plexus were analyzed including corneal nerve fibre length (CNFL), corneal nerve fibre density (CNFD), corneal nerve branch density (CNBD), and tortuosity coefficient (TC). Moreover, correlation analysis was performed to explore the relationship between the alterations of DE and nerve parameters.
RESULTS: The symptoms and signs of DE were significantly improved after one-month SL therapy. The score of Ocular Surface Disease Index (OSDI) and corneal fluorescein staining (CFS) score decreased from 57.28 (2.780-100.0) and 13.1 ± 2.4 to 8.86 (0-50) and 8 (0-15), respectively, while fluorescein tear break-up time (FBUT) increased from (0.4 ± 0.5) s to (2.2 ± 2.0) s (all p < 0.001). Moreover, CNFL and CNFD were considerably increased after one-month SL therapy (all p < 0.05). The correlation analysis revealed that the first and average non-invasive breakup times (f-NIBUT, a-NIBUT) negatively correlated with CNBD (both p < 0.05).
CONCLUSIONS: One-month SL therapy may not only alleviate the symptoms and signs of severe DE, but also improve the morphology of corneal subbasal nerve plexus. SL therapy has great potential in the management of ocular discomfort symptoms and refractory ocular pain associated with corneal nerve abnormalities in severe DE patients.