Update on corneal neurotisation

Corneal neurotisation describes surgical restoration of nerve growth into the cornea to restore corneal sensation and trophic function. It represents an exciting and effective emerging treatment for neurotrophic keratopathy. Techniques described to date involve either direct nerve transfer or an interpositional nerve graft coapted to a healthy donor nerve. We review the experience to date with particular emphasis on a detailed review of techniques, outcomes and current thoughts.

Download Full-text

Corneal neurotisation by great auricular nerve transfer and scleral-corneal tunnel incisions for neurotrophic keratopathy

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2018-312563 ◽

2018 ◽

Vol 103 (9) ◽

pp. 1235-1238 ◽

Cited By ~ 12

Author(s):

Nate Jowett ◽

Roberto Pineda II

Keyword(s):

Visual Acuity ◽

Confocal Microscopy ◽

Donor Site ◽

Nerve Transfer ◽

Donor Site Morbidity ◽

Nerve Fibres ◽

Novel Technique ◽

Great Auricular Nerve ◽

Early Results ◽

Neurotrophic Keratopathy

Background/AimsMedical 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.MethodsSensory 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.ResultsImprovements in visual acuity, cornealpachymetry, corneal esthesiometry, and corneal neurotisation as assessed by invivo confocal microscopy were observed within nine months of surgery in bothpatients.ConclusionCorneal neurotisation by interposition grafttransfer of great auricular nerve fibres via scleral-corneal tunnel incisionsappears effective in the management of neurotrophic keratopathy.

Download Full-text

An anatomic study of the spinal accessory nerve: Extended harvest permits direct nerve transfer to distal plexus targets

Clinical Anatomy ◽

10.1002/ca.20545 ◽

2007 ◽

Vol 20 (8) ◽

pp. 899-904 ◽

Cited By ~ 28

Author(s):

Torpon Vathana ◽

Mikko Larsen ◽

Godard C.W. de Ruiter ◽

Allen T. Bishop ◽

Robert J. Spinner ◽

...

Keyword(s):

Nerve Transfer ◽

Spinal Accessory Nerve ◽

Accessory Nerve ◽

Anatomic Study ◽

Spinal Accessory ◽

Direct Nerve

Download Full-text

Nerve Transfer Versus Nerve Graft for Reconstruction of High Ulnar Nerve Injuries

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2017.01.027 ◽

2017 ◽

Vol 42 (4) ◽

pp. 265-273 ◽

Cited By ~ 12

Author(s):

Asser A. Sallam ◽

Mohamed S. El-Deeb ◽

Mohamed A. Imam

Keyword(s):

Ulnar Nerve ◽

Nerve Transfer ◽

Nerve Graft ◽

Nerve Injuries

Download Full-text

Facial reanimation with interposition nerve graft or masseter nerve transfer: a comparative retrospective study

Neural Regeneration Research ◽

10.4103/1673-5374.324862 ◽

2022 ◽

Vol 17 (5) ◽

pp. 1125

Author(s):

Zhao-Yan Wang ◽

Hao Wu ◽

Wei Wang ◽

Wen-Jin Wang ◽

Wei-Dong Zhu ◽

...

Keyword(s):

Retrospective Study ◽

Nerve Transfer ◽

Nerve Graft ◽

Facial Reanimation

Download Full-text

Corneal neurotisation for neurotrophic keratopathy with a sural nerve autograft: a case report

Australasian Journal of Plastic Surgery ◽

10.34239/ajops.v4n2.236 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

David Moore ◽

Chameen Samarawickrama ◽

Krishna Tumuluri ◽

Quan Ngo

Keyword(s):

Visual Acuity ◽

Sural Nerve ◽

Healthy Donor ◽

Cerebellopontine Angle ◽

Nerve Tissue ◽

Corneal Disease ◽

Stage 1 ◽

Nerve Autograft ◽

Operative Monitoring ◽

Neurotrophic Keratopathy

Neurotrophic keratopathy is a corneal disease characterised by reduced corneal sensation. Corneal neurotization is the transfer of healthy donor nerve tissue to the cornea to restore sensation. An 11-year-old male presented with reduced Mackie Stage 1 neurotrophic keratopathy from de-bulking of a cerebellopontine angle arachnoid cyst. He underwent minimally invasive indirect corneal neurotization with a sural nerve autograft to ipsilateral supratrochlear nerve and cornea. Close and objective post-operative monitoring of donor sites, the cornea, visual acuity, and tear production clearly demonstrate the efficacy of this technique, and the timeline of clinical improvement.

Download Full-text

Axillary Nerve Injury

10.1093/med/9780190617127.003.0024 ◽

2018 ◽

Author(s):

Russell A. Payne ◽

Elias B. Rizk

Keyword(s):

Nerve Injury ◽

Surgical Repair ◽

Sports Injuries ◽

External Rotation ◽

Nerve Repair ◽

Nerve Transfer ◽

Axillary Nerve ◽

Nerve Grafting ◽

Surgical Exploration ◽

Direct Nerve

Axillary nerve injury has been associated with sports injuries, especially those involving anterior shoulder dislocation. The nerve injury leads to weakness of the deltoid and teres minor muscles, which impairs abduction and external rotation of the arm at the shoulder. Electrodiagnostic studies are helpful for determining extent of reinnervation and recovery after injury. In the absence of clinical or electrodiagnostic signs of recovery 3 to 6 months after injury, it is appropriate to offer surgical exploration. The options for surgical repair include direct nerve repair, nerve grafting, and nerve transfer. In appropriately selected individuals, outcomes are favorable.

Download Full-text