ArticleThe British journal of ophthalmology2025
Neuropathic corneal pain following refractive surgery: risk factors, clinical manifestations, imaging and proteomic characteristics.
Article in The British journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Neuropathic Corneal Pain and Blepharospasm: A Case Series.Diagnostics (Basel, Switzerland) · 2026Article
- Axial length-based reference values for corneal sensitivity in a pediatric population.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Applications of Artificial Intelligence in Corneal Nerve Images in Ophthalmology.Diagnostics (Basel, Switzerland) · 2026Review
- Electrotherapy in the management of neuropathic corneal pain: narrative review.Experimental biology and medicine (Maywood, N.J.) · 2026Review
- Gut-ocular surface axis in dry eye disease: phenotype-specific mechanisms, evidence, and microbiome-targeted interventions.Frontiers in cellular and infection microbiology · 2026Review
- Focused Narrative Review: Non-Pharmacological, Noninvasive Neurostimulation or Neuromodulation Treatment of Ocular Neuropathic Pain.Clinical ophthalmology (Auckland, N.Z.) · 2026Review
- Vitamin abnormalities in neuropathic corneal pain.Eye and vision (London, England) · 2025Review
- Scleral lenses and PROSE: indications, complications, and future challenges.Medical hypothesis, discovery & innovation ophthalmology journal · 2025Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
aimsTo identify the risk factors for neuropathic corneal pain (NCP) following corneal refractive surgery and to report its clinical manifestations, imaging and proteomic characteristics.
methodsThis 1 year prospective cohort study included 100 eyes that underwent small incision lenticule extraction (SMILE) or laser-assisted in situ keratomileusis (LASIK). Ocular surface assessments, in-vivo confocal microscopy scans, tear neuromediators and proteomics analyses were performed. NCP was assessed using the ocular pain assessment survey. Univariate and multivariate analyses were conducted to identify the risk factors associated with postoperative NCP.
resultsThe incidence of NCP was 13.3% and 10.5% after SMILE and LASIK, respectively (p=0.70). In SMILE, preoperative manifest refractive spherical equivalent (MRSE) and spherical power (both p=0.02) were significantly higher in the NCP compared with the non-NCP group. In LASIK, NCP eyes had a significantly lower corneal nerve fibre length (CNFL) (p=0.02), lower nerve fractal dimension (p=0.003), higher nerve fibre width (p=0.04) and larger neuroma area (p=0.04) than non-NCP eyes. In SMILE, higher preoperative MRSE was a significant risk factor for postoperative NCP (95% CI: 0.48-1.96, p=0.04). An MRSE greater than -8.0 diopter was 9.57 times more likely to develop postoperative NCP (OR=9.57, p=0.002). In LASIK, lower preoperative corneal nerve fibre density (95% CI:0.13-1.11, p=0.05) and CNFL (95% CI:0.09-1.25, p=0.05) were significant risk factors for postoperative NCP. Significant increases in tear nerve growth factor, calcitonin gene-related peptide, Frizzled class receptor 7 and nucleoside-diphosphate kinase three were observed in postoperative NCP.
conclusionsThe reported characteristics and risk factors would identify patients susceptible to NCP after corneal refractive surgery.
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