Indirect corneal neurotization leads to sustained nerve regeneration in neurotrophic keratopathy

Indirect corneal neurotization (ICN) using the supratrochlear and great auricular nerves leads to long-term restoration of corneal nerve function and sensitivity in patients with neurotrophic keratopathy, according to a study.

The study followed 19 patients for an average of 40 months after undergoing ICN. Corneal sensitivity improved in 84% of eyes, including more than half that were completely anesthetic prior to surgery. In vivo confocal microscopy confirmed structural nerve regeneration in all eyes within 2 years, with significant gains in nerve density and branching.

Visual acuity and corneal thickness remained stable. There were no serious adverse events reported. Mild, transient side effects, such as earlobe numbness and neuroma formation, were observed but resolved over time. In 4 patients, secondary penetrating keratoplasty was successfully performed following ICN, with histological confirmation of axonal regrowth.

Reference
Garcin T, Benkhatar H, Rappeneau Q, et al. Corneal neurotization using the supratrochlear nerve with a great auricular nerve graft for neurotrophic keratopathy: long-term results. Am J Ophthalmol. 2025;S0002-9394(25)00304-6. doi: 10.1016/j.ajo.2025.06.014. Epub ahead of print. PMID: 40562087.