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Br J Ophthalmol. 2018 Nov 23. pii: bjophthalmol-2018-312563. doi: 10.1136/bjophthalmol-2018-312563. [Epub ahead of print]

Corneal neurotisation by great auricular nerve transfer and scleral-corneal tunnel incisions for neurotrophic keratopathy.

Author information

1
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, USA nate_jowett@meei.harvard.edu.
2
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, USA.

Abstract

BACKGROUND/AIMS:

Medical management of neurotrophickeratopathy is challenging and costly. Supra-orbital nerve transfer to thecornea has proven effective for management of keratopathy, but yieldsconsiderable donor site morbidity. Herein, a novel technique for reinnervationof the anaesthetic cornea is presented and early results characterised.

METHODS:

Sensory fibres of the ipsilateral greatauricular nerve were directed via an interposition graft to the anteriorcorneal stroma using scleral-corneal tunnel incisions in two patients withgrade III neurotrophic keratopathy.

RESULTS:

Improvements in visual acuity, cornealpachymetry, corneal esthesiometry, and corneal neurotisation as assessed by invivo confocal microscopy were observed within nine months of surgery in bothpatients.

CONCLUSION:

Corneal neurotisation by interposition grafttransfer of great auricular nerve fibres via scleral-corneal tunnel incisionsappears effective in the management of neurotrophic keratopathy.

KEYWORDS:

cervical plexus; corneal disease; keratitis; nerve regeneration; trigeminal nerve

Conflict of interest statement

Competing interests: None declared.

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