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Updated: Jul 13, 2025
Author Spotlight: Advancing Corneal Innervation Research Through Innovative Models
Published on: December 8, 2023
Corneal Neurotization: Preoperative Patient Workup and Surgical Decision-making
Simeon C Daeschler1,2, Jyh Haur Woo3,4,5, Isra Hussein3
1From the SickKids Research Institute, Neuroscience and Mental Health Program, Toronto, Ontario, Canada.
Background:
The use of sensory nerve transfers to the anesthetic cornea has transformed the treatment of neurotrophic keratopathy by restoring ocular surface sensation and activating dysfunctional epithelial repair mechanisms. However, despite numerous reports on surgical techniques, there is a scarcity of information on the interdisciplinary management, preoperative assessment, and surgical decision-making, which are equally critical to treatment success.
Methods:
This Special Topic presents a standardized, interdisciplinary preoperative workup based on our 10-year experience with corneal neurotization in 32 eyes of patients with neurotrophic keratopathy.
Results:
Our assessment includes a medical history review, ophthalmic evaluation, and systematic facial sensory donor nerve mapping for light touch and pain modalities. This approach enables evidence-based patient selection, optimal surgery timing, and suitable donor nerve identification, including backup options.
Conclusions:
Based on a decade-long experience, this special topic highlights the importance of interdisciplinary collaboration and provides a practical roadmap for optimizing patient selection and surgical decision-making in patients undergoing corneal neurotization.
