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.
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.