Corneal neurotization for neurotrophic keratopathy: Review of surgical techniques and outcomes

Abstract

Neurotrophic keratopathy is a degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia. Injuries to neurotrophic corneas are notoriously difficult to treat and have traditionally been approached with supportive management. However, recent progress in the field of corneal neurotization has given new direction for addressing nerve loss directly by stimulating new nerve growth onto the cornea from nearby sensory nerves transferred to the perilimbal region. Herein, we review the surgical techniques utilized in corneal neurotization, including direct transfers and the use of nerve grafts. Considerations in surgical approach, as well as factors that influence prognosis and outcomes of the surgical intervention are also discussed.

Keywords: Anesthetic cornea; Corneal nerve; Herpetic keratopathy; Nerve coaptation; Neurotization; Neurotrophic cornea; Neurotrophic keratopathy.