A corneal surface study in patients after laser keratomilesis

Cover Page


The cornea of the human eye is not only refracts the light, but also acts as a convex mirror, which reflects the surroundings. In ophthalmology, an image reflected by its anterior surface is known as the 1st Purkinje image. Characteristics of this image are determined by the properties of the light source and the state of corneal surface. At the present time, there are many methods in ophthalmology to study various properties of the cornea, but most of them either require expensive equipment or are qualitative and not informative. Meanwhile, a “shining” characteristic of the cornea in general is assessed subjectively and is not properly addressed in the ophthalmic literature. Our work was conducted to study the possibility of applying the method of measuring the reflective ability of the cornea to measure the state of its anterior surface. Our study involved men and women aged 18–45 years after laser-assisted in situ keratomilesis (LASIK). With our new method of measuring the corneal reflectance, we investigated patients before surgery, day 1 post-op and after 1 week. Each study case included a measurement of the reflectivity of the cornea after blinking, and after 15 sec. We found that on the day 1 after surgery corneal reflectivity increases, at the same time, 15 sec after blinking it is reduced to normal. This suggests a reduction of the tear film stability and that the patients had some symptoms of corneal syndrome, and as a consequence, increased tear production. One week after surgery, we observed a different picture: the reflective power of the cornea decreased. We consider this to be a sign of corneal nerves damage and decreased tear production.

About the authors

Vyacheslav Igorevich Maslennikov

S. M. Kirov Military Medical Academy

Email: v.maslennikoff@gmail.com
student residency in ophthalmology

Sergey Alekseyevich Koskin

S. M. Kirov Military Medical Academy

Email: koskin@mailbox.alkor.ru
MD, associate professor, deputy head, Department of Ophthalmology

Yuriy Yevgenyevich Shelepin

I. P Pavlov Institute of physiology, Russian Academy of Sciences

Email: yshelepin@yandex.ru
MD, professor, head of vision physiology department

Aleksandr Vladimirovich Yan

S. M. Kirov Military Medical Academy

Email: yan@gmail.com
MD, head of laser department. Department of Ophthalmology


  1. Першин К. Б. Осложнения LASIK: анализ 12500 операций / К. Б. Першин, Н. Ф. Пашинова // Клиническая офтальмология, журн. — 2000. — Т. 1, № 4. — С. 96.
  2. Гацу А. Ф. Инфракрасные лазеры (13 мкм) в хирургии наружных отделов глаза (клинико-функциональное исследование): Автореф. дис… д-ра мед. наук / А. Ф. Гацу. — СПб., 1995.
  3. Паштаев Н. П., Сусликов С. В. Лазерная кератопластика на установке «ЛИК-100» для коррекции гиперметропии и астигматизма // Федоровские чтения: сб. науч. ст. — М., 2002. — С. 126–128.
  4. Семенов А. Д. Применение иттербий-эрбиевого лазера для хирургической коррекции гиперметропии и гиперметропического астигматизма / А. Д. Семенов, А. В. Сорокин // Хирургические методы лечения близорукости. — М., 1984. — С. 72–78.
  5. Alio J. K. Correction of Hyperopia with Noncontact Ho: YAG Laser Termal Keratoplasty / J. K. Alio, M. M. Ismail, J. L. S. Pego // J. Refract. Surg, mag. — 1997. — Vol. 13. — P. 17–22.
  6. Sugar A. Laser in situ keratomileusis for myopia and astigmatism: safety and efficacy / A. Sugar, C. J. Rapuano, W. W. Culbertson, D. Huang, G. A. Varley, P. J. Agapitos, V. P. de Luise, D. D. Koch // Ophthalmology, mag. — 2002. — Vol. 109 (1). — P. 175–187.
  7. Сомов Е. Е. Синдром слезной дисфункции (анатомо-физиологические основы, диагностика, клиника и лечение) — Спб. — 2011. — 85–90 с.
  8. Бржеский В. В. Роговично-конъюнктивальный синдром (диагностика, клиника, лечение). — СПб.: Левша. — 2003. — 120 с.
  9. Bir L. S. Blink reflex in hyperthyroidism electromyography // Clin. Neurophysiol, mag. — 2001. — Vol. 41, N 1. — P. 49–52.
  10. Vanley G. T. Interpretation of tear film break-up / G. T. Vanley, I. H. Leopold, T. H. Gregg // Arch. Ophthalmol, mag. — 1977. — Vol. 95 — P. 445–448.
  11. Бржеский В. В. Роговично-конъюнктивальный ксероз (диагностика, клиника, лечение) / В. В. Бржеский, Е. Е. Сомов // — СПб.: Сага. — 2002. — 142 с.
  12. Бржеский В. В. Синдром «сухого глаза» / В. В. Бржеский, Е. Е. Сомов. — СПб.: Аполлон. — 1998. — 96 с.
  13. Feenstra R. PG. Comparison of fluorescein and Rose Bengal staining / R.PG. Feenstra, S.CG. Tseng // Ophthalmology, mag. — 1992. — V. 99, N 4. — P. 605–617.
  14. Van Bijsterveld O. P. Diagnostic tests in the sicca syndrome / O. P. van Bijsterveld // Arch. Ophthalmol, mag. — 1969. — Vol. 82 (1). — P. 10–14.
  15. Norn M. S. Lissamine Green: vital staining of cornea and conjunctiva // ACTA Ophthalmologica. — 1973. — N 51. — P. 483–491.
  16. Calvillo M. P. Corneal reinnervation after LASIK: prospective 3-year longitudinal study / M. P. Calvillo, J. W. McLaren, D. O. Hodge, W. M. Bourne // Invest Ophthalmol. Vis. Sci, mag. — 2004. — Nov. 45 (11):3991. — P. 6.



Abstract - 404

PDF (Russian) - 527



Copyright (c) 2013 Maslennikov V.I., Koskin S.A., Shelepin Y.Y., Yan A.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies