Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature

Abstract

Neurotrophic keratopathy (NK) is a rare degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia or anesthesia. Neurotrophic corneal ulcers are notoriously difficult to treat and can lead to blindness. Corneal neurotization (CN) is a recent surgical technique aimed at restoring corneal sensation and may offer a definitive treatment in the wake of NK. Herein, we review the surgical techniques utilized in direct and indirect CN. Technical considerations, outcomes, current limitations and future perspectives are also discussed. This article highlights the key points of this promising procedure and biological aspects that will help provide the best treatment options for patients with severe NK.

Keywords: Cornea; Corneal innervation; Corneal nerves; Corneal neurotization; Cornée; In vivo confocal microscopy; Innervation cornéenne; Kératopathie neurotrophique; Microscopie confocale in vivo; Nerfs cornéens; Neurotisation cornéenne; Neurotrophic keratopathy.