Ipsilateral supraorbital nerve transfer in a case of recalcitrant neurotrophic keratopathy with an intact ipsilateral frontal nerve: A novel surgical technique

Autor: Frances Jacinto, Edgar Espana, Maximilian Padilla, Amier Ahmad, Ilya Leyngold
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: American Journal of Ophthalmology Case Reports, Vol 4, Iss C, Pp 14-17 (2016)
Druh dokumentu: article
ISSN: 2451-9936
DOI: 10.1016/j.ajoc.2016.07.001
Popis: Purpose: To report a case of regained corneal sensation and function in a patient with neurotrophic keratopathy due to direct damage to the long ciliary nerves by performing a corneal neurotization procedure using ipsilateral supraorbital nerve. Surgical technique is described in detail as well as a review of the literature on corneal neurotization. Observations: A patient with devastating corneal anesthesia and poor visual acuity refractory to other treatments underwent a new surgical technique involving an ipsilateral supraorbital nerve transfer to the surrounding limbus to restore corneal sensation. At 8 months follow up, there was resolution of corneal stromal opacification documented with photographs and greatly improved corneal sensation by testing with a wisp of cotton in all 4 quadrants. Her visual acuity had improved, and at two years she was stable with even more improvement in visual acuity and ocular surface health. Conclusions and importance: We present the first successful case of corneal neurotization with ipsilateral supraorbital nerve in a patient with corneal anesthesia from a local injury to the long ciliary nerves. Our case demonstrates that the described method of corneal neurotization is a viable option for patients with recalcitrant neurotrophic keratopathy and an intact ipsilateral frontal nerve.
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