Minimally Invasive Corneal Neurotization Provides Sensory Function, Protects Against Recurrent Ulceration, and...

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Corneal Surgery

Background:

• Neurotrophic keratopathy (NK) is a severe corneal disease characterized by impaired corneal sensation and a high risk of ulceration.
• Minimally invasive corneal neurotization aims to restore corneal nerve function and improve healing.
• Understanding factors influencing sensory recovery is vital for optimizing treatment strategies.

Purpose of the Study:

• To measure sensory recovery following minimally invasive corneal neurotization.
• To identify patient and technical factors affecting sensory recovery, ulceration rates, and visual outcomes.

Main Methods:

• Retrospective case series of 23 patients (28 eyes) with NK undergoing indirect corneal neurotization.
• Corneal sensitivity assessed using Cochet-Bonnet aesthesiometry (CBA).
• Epithelial breakdown and visual acuity were secondary outcome measures.

Main Results:

• Corneal sensitivity (CBA) significantly improved from baseline (3.5 mm) to 24 months post-surgery (44.1 mm; P < .001).
• Ipsilateral donor nerve grafts resulted in higher mean CBA at 3 months compared to contralateral grafts (P = .001).
• Visual acuity improved, and epithelial breakdown occurred in 32.1% of eyes post-surgery.

Conclusions:

• Corneal neurotization effectively restores corneal sensation and visual acuity over time.
• Sensory recovery plays a key role in protecting against epithelial breakdown and recurrent ulceration.
• Optimizing surgical techniques, such as using ipsilateral grafts, may enhance sensory recovery and clinical outcomes.