Viterbi Family Department of Ophthalmology, UC San Diego, San Diego, CA, USA.
Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois Chicago, Chicago, IL, USA.
Ocul Surf. 2021 Apr;20:163-172. doi: 10.1016/j.jtos.2021.02.010. Epub 2021 Feb 26.
Neurotrophic keratopathy is a degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia. Injuries to neurotrophic corneas are notoriously difficult to treat and have traditionally been approached with supportive management. However, recent progress in the field of corneal neurotization has given new direction for addressing nerve loss directly by stimulating new nerve growth onto the cornea from nearby sensory nerves transferred to the perilimbal region. Herein, we review the surgical techniques utilized in corneal neurotization, including direct transfers and the use of nerve grafts. Considerations in surgical approach, as well as factors that influence prognosis and outcomes of the surgical intervention are also discussed.
神经营养性角膜病变是一种退行性疾病,其中角膜神经的损伤导致角膜知觉减退。神经营养性角膜损伤的治疗极具挑战性,传统上一直采用支持性治疗方法。然而,角膜神经再支配领域的最新进展为通过刺激从转移到角膜缘区域的附近感觉神经到角膜上的新神经生长,为直接解决神经损失提供了新的方向。在此,我们回顾了角膜神经再支配中使用的手术技术,包括直接转移和使用神经移植物。还讨论了手术方法中的注意事项以及影响手术干预预后和结果的因素。