Corneal neurotization shows long-term benefits in neurotrophic keratopathy with facial palsy

Indirect corneal neurotization using a sural nerve graft can restore corneal sensation, improve vision, and enhance ocular surface health in patients with neurotrophic keratopathy and facial palsy, with benefits sustained over long-term follow-up, according to a study.

The prospective trial included 14 patients who underwent indirect corneal neurotization as part of a staged facial reanimation procedure. The technique involved coapting a sural nerve graft to the supratrochlear nerve, with fascicles placed subconjunctivally around the cornea.

At a mean follow-up of more than 4 years, patients showed significant gains in corneal sensation, visual acuity, and tear film stability. Improvements in ocular surface integrity, reduction of corneal opacities, and decreased vascularization were observed within 3 to 6 months after surgery and persisted long-term.

Reference
Albavera-Giles T, Vera-Duarte GR, Ortiz-Morales G, et al. Indirect Corneal Neurotization: Long-Term Outcomes Using a Sural Nerve Graft in Patients With Facial Palsy and Neurotrophic Keratopathy. Cornea. 2025;doi: 10.1097/ICO.0000000000003969. Epub ahead of print. PMID: 40833019.