Abstract
Neurotrophic keratopathy is a corneal disease characterised by reduced corneal sensation. Corneal neurotization is the transfer of healthy donor nerve tissue to the cornea to restore sensation. An 11-year-old male presented with reduced Mackie Stage 1 neurotrophic keratopathy from de-bulking of a cerebellopontine angle arachnoid cyst. He underwent minimally invasive indirect corneal neurotization with a sural nerve autograft to ipsilateral supratrochlear nerve and cornea. Close and objective post-operative monitoring of donor sites, the cornea, visual acuity, and tear production clearly demonstrate the efficacy of this technique, and the timeline of clinical improvement.
Highlights
Neurotrophic keratopathy is a corneal disease characterised by reduced corneal sensation
Neurotrophic keratopathy arises from any condition disrupting the trigeminal innervation of the cornea, resulting in progressive corneal ulceration
Corneal neurotisation was first described by Terzis and colleagues in 2009.2 They performed direct nerve transfer of the contralateral supratrochlear or supraorbital nerve through a bicoronal incision
Summary
Neurotrophic keratopathy is a corneal disease characterised by reduced corneal sensation. Corneal neurotisation is a surgical technique that addresses the underlying pathophysiology by the transfer of healthy donor nerve to the dennervated cornea. Moore et al: Corneal neurotisation for neurotrophic keratopathy with a sural nerve autograft: a case report. Corneal sensation measured by Cochet-Bonnet aesthesiometry was 60 mm in the right eye and 5–15 mm in the left eye. Slit lamp microscopy revealed punctate keratopathy of the left cornea, consistent with Mackie stage one disease. In-vivo confocal microscopy showed a complete absence of nerves in the left subepithelial corneal plexus. The nerve fascicles were separated and inset into four 400-micron diameter scleral tunnels using 10-0 Vicryl sutures (Ethicon, Highway 22 N, Somerville, New Jersey, USA) (Figure 1). Confocal microscopy at 16 months showed new nerves in the corneal subepithelial plexus
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
