Department of Ophthalmology, University of Pittsburgh Schools of Medicine and Engineering, Pittsburgh, PA.
Department of Bioengineering, University of Pittsburgh Schools of Medicine and Engineering, Pittsburgh, PA.
Cornea. 2020 May;39(5):657-660. doi: 10.1097/ICO.0000000000002269.
Neurotrophic keratopathy (NK) produces persistent epithelial erosion which is hard to treat effectively. Recently, corneal neurotization surgery has produced reinnervation of the cornea with resolving neurotrophic keratopathy. We hypothesized that the generation of corneal epithelial nerves after neurotization surgery would not only restore the integrity of corneal epithelium but also produce a change in the configuration of the palisades of Vogt (POV), which houses the corneal epithelial stem cells.
We assessed a patient with unilateral congenital corneal anesthesia with optical coherence tomography pre-neurotization and post-neurotization.
Over the course of 2 years, the patient gained corneal epithelial sensation and corneal and limbal epithelium was restored to normal thickness with corresponding changes in the POV.
The intimate relationship between epithelium and sensory nerves of the cornea has been well documented; however, changes in the corneal epithelial stem cell niche in conjunction with development of innervation have not previously been reported. Considering the architecture of the corneal nerves in conjunction with the architecture of the POV may assist in developing treatments that can support the regeneration and maintenance of epithelium during nerve regeneration.
神经营养性角膜病变（NK）会导致持续的上皮糜烂，难以有效治疗。最近，角膜神经化手术已实现角膜的再神经支配，从而解决神经营养性角膜病变。我们假设神经化手术后角膜上皮神经的产生不仅会恢复角膜上皮的完整性，还会改变容纳角膜上皮干细胞的 Vogt 氏栅状线（POV）的形态。
我们使用光学相干断层扫描评估了一位单侧先天性角膜感觉丧失的患者在神经化手术前和神经化手术后的情况。
在 2 年的时间里，患者获得了角膜上皮感觉，角膜和缘部上皮恢复正常厚度，相应地 POV 也发生了变化。
角膜上皮和感觉神经之间的密切关系已有充分的文献记载；然而，支配神经发育的同时，角膜上皮干细胞龛位的变化以前尚未报道过。考虑到角膜神经的结构与 POV 的结构相结合，可能有助于开发能够在神经再生过程中支持上皮再生和维持的治疗方法。
