Corneal neurotization shows sustained improvements in sensation and disease stage in neurotrophic keratopathy

Corneal neurotization (CN) is associated with sustained improvements in corneal sensation and disease severity in patients with neurotrophic keratopathy over long-term follow-up, according to a study.

The analysis included 58 eyes from 58 patients who underwent CN between 2016 and 2024 at Duke University Hospital and the Leyngold Institute for Plastic Surgery, all performed by a single surgeon.

Demographic data and clinical measures were assessed at 6–12 months postoperatively, and at the last follow-up visit of at least 12 months. Median follow-up was 30 months.

There were significant improvements in Mackie stage and corneal sensation at both postoperative time points compared with baseline. Best-corrected visual acuity did not significantly change over time. Greater improvement was observed in younger patients and in those with peripheral, rather than central, neurotrophic keratopathy etiologies. Use of cenegermin was not associated with significant differences in outcomes.

Complications, which were not vision-threatening or disfiguring, were reported in 4 patients. Among patients who required additional ocular surface rehabilitative procedures after CN, 82% tolerated these surgeries without corneal decompensation.

Reference
Robbins JO, Okrent AL, Grigore E, et al. Long-term outcomes of corneal neurotization for neurotrophic keratopathy: a dual center, single surgeon retrospective study. Plast Reconstr Surg. 2025;doi: 10.1097/PRS.0000000000012743. Epub ahead of print. PMID: 41428966.