Minimally invasive corneal neurotization improves outcomes in neurotrophic keratopathy

Minimally invasive corneal neurotization surgery is a safe and effective treatment for neurotrophic keratopathy (NK), even in rural, socioeconomically disadvantaged populations, according to a study.

A new retrospective study from West Virginia University analyzed outcomes from 13 patients who underwent corneal neurotization. Most patients had advanced NK (Mackie stage 2 or 3), and nearly 40% had a history of diabetes. Despite a high mean social deprivation index score of 70, all patients achieved corneal epithelialization with no recurrence of epithelial defects over an average 18-month follow-up.

Surgeries involved indirect nerve grafting using lid crease incisions and nerves harvested from the supraorbital, supratrochlear, or infraorbital regions, in collaboration between cornea and oculoplastics specialists.

Overall, 8 patients experienced improved corneal sensation, and 9 saw gains in visual acuity. Corneal transplants post-neurotization were required in 4 patients, and 1 underwent adjunctive chemoembolization for corneal neovascularization. Visual acuity improvements were statistically significant at both 1 year and final follow-up.

Reference
Dahshan D, Wang D, Toker E, et al. Minimally invasive corneal neurotization surgery and outcomes in a rural population. Int Ophthalmol. 2025 Jul 14;45(1):290. doi: 10.1007/s10792-025-03674-4. PMID: 40660045.