Dynamic correlation between corneal sensitivity and subjective symptoms in patients with Chronic corneal ulcers

Purpose: This study assessed the correlation between corneal sensitivity and subjective symptoms in patients with chronic corneal ulcers before and after treatment. Methods: Corneal sensitivity was measured with Cochet-Bonnet aesthesiometry in twenty patients with mean age of53 years SD±20.65. Impression cytology was used to assess conjunctivalization, inflammation and keratinization. The epithelial integrity and stromal reaction were determined by anterior segment OCT. Treatment included either conservative measures or surgical ocular surface reconstruction. A questionnaire on subjective symptoms was implemented in order to obtain comparable data about their severity and effect on everyday life. Results: Mean corneal aesthesiometry was 143.03±81.68 mm/grms before treatment and 72.48±72.80 mm/grms on follow-up (p=0.001). An inverse correlation between age and corneal sensitivity was observed before treatment (p=0.002), but not after (p=0.102). Anterior segment OCT on follow-up demonstrated epithelialized corneal surface, reduced stromal reaction and scar tissue preventing further melting. All tested subjective symptoms demonstrated significant change after treatment except driving. Spearman’s analysis demonstrated a correlation between corneal sensitivity and pain (p=0.033), hyperemia (p=0.009) and driving (p=0.043). The change in corneal sensitivity correlated with tearing reduction (p=0.046) and prolonged tolerance to phone use (p=0.044). Conclusions: Cochet-Bonnet aesthesiometry is a useful diagnostic tool for evaluating corneal nerve function and monitoring the effect of treatment.