Corneal Neurotisation in Neurotrophic Keratopathy: A Retrospective Analysis of Functional Outcomes and Clinical...

BACKGROUND: Neurotrophic keratopathy (NK) is a rare, chronic corneal disorder resulting from impaired sensory innervation. Corneal neurotisation, which restores corneal innervation through nerve transfer, has emerged as a promising causal treatment approach. This retrospective study aimed to evaluate the clinical outcomes of corneal neurotisation in patients with NK.

MATERIAL AND METHODS: We retrospectively reviewed all patients who underwent indirect corneal neurotisation using an autologous sural nerve interposition graft for NK at the Eye Center at Medical Center, University Freiburg. Demographic characteristics, aetiology, postoperative corneal sensitivity, epithelial integrity, visual acuity, and complications were analysed descriptively.

RESULTS: A total of four patients with Mackie stages 2 to 3 were included in the analysis. All developed measurable corneal sensitivity after surgery, whereas no sensitivity was present preoperatively. Complete corneal epithelialisation was achieved in every case, with no recurrent epithelial defects during follow-up (4 - 49 months). No intraoperative or postoperative complications occurred. All patients reported subjective improvement, including reduced discomfort, keratitis, and recurrent erosions.

CONCLUSION: Indirect corneal neurotisation using an autologous sural nerve graft appears to be a safe and effective option for treating neurotrophic keratopathy. The procedure can restore corneal sensitivity, promote epithelial healing, and substantially alleviate symptoms, thereby improving patients' overall quality of life.