Corneal neurotization for neurotrophic keratopathy: a case report of two patients from different age groups

To describe the techniques and the successful outcomes of corneal neurotization (CN) for the treatment of neurotrophic keratopathy (NK) in two patients from different age groups.

A detailed clinical examination and comprehensive systemic workup were performed to determine the etiology of NK. Both cases were managed surgically with CN and followed for 3 years postoperatively at the King Khaled Eye Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

Two eyes of a 66-year-old male and a 22-month-old boy who were diagnosed with NK and refractory to conservative therapy underwent CN. The first patient underwent indirect corneal neurotization for the management of NK in the right eye from the ipsilateral infraorbital nerve using a sural nerve interposition graft from the left leg, while the second patient underwent indirect corneal neurotization for the management of NK in the left eye from the contralateral right supraorbital nerve using a sural nerve interposition graft from the left leg. The symptoms improved following the procedure as well as the corneal sensation, with improvement of the NK in both patients. At the three-year follow-up, our patients showed no complications or NK recurrence.

CN is a valuable surgical technique for the management of recalcitrant NK and possibly for restoring corneal sensation in some with NK prior to the development of irreversible stromal damage.