Wolkow Natalie, Habib Larissa A, Yoon Michael K, Freitag Suzanne K
Ophthalmic Plastic Surgery Service, Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA, USA.
Semin Ophthalmol. 2019;34(7-8):473-487. doi: 10.1080/08820538.2019.1648692. Epub 2019 Aug 1.
Corneal neurotization is an innovative surgical approach for restoring corneal sensation, whereby the sensory functions of a normal donor nerve are rerouted to an anesthetic cornea. Many variations upon this basic surgical principal have been introduced and have proven successful in ameliorating corneal sensation in patients. It is unclear whether one surgical approach is superior to another, as each has advantages and disadvantages. Surgical approaches differ in the donor nerve selected and in whether a nerve graft is required. Surgical techniques have varied in the location, number and extent of incisions, methods of nerve coaptation, the number of surgeons required, the equipment and materials utilized and the duration of the procedure. The current review provides an overview of developments in this nascent field. A review of all peer-reviewed publications on corneal neurotization was performed. The various approaches to corneal neurotization are compared and discussed. The least morbid, simplest, most expedient and successful surgical approaches will ultimately become the most utilized.
角膜神经化是一种用于恢复角膜感觉的创新性手术方法，即把正常供体神经的感觉功能重新导向麻醉的角膜。基于这一基本手术原理已引入了多种变体，并已证明在改善患者角膜感觉方面是成功的。尚不清楚一种手术方法是否优于另一种，因为每种方法都有优缺点。手术方法在所选供体神经以及是否需要神经移植方面存在差异。手术技术在切口的位置、数量和范围、神经吻合方法、所需外科医生数量、使用的设备和材料以及手术持续时间等方面各不相同。本综述概述了这一新兴领域的发展情况。对所有关于角膜神经化的同行评审出版物进行了综述。对角膜神经化的各种方法进行了比较和讨论。创伤最小、最简单、最便捷且成功的手术方法最终将得到最广泛的应用。
