Gross Jeffrey N, Bhagat Neel, Tran Khoa, Liu Shaohui, Boente Charline S, Ali Asim, Borschel Gregory H
From the Division of Plastic Surgery.
Indiana University School of Medicine.
Plast Reconstr Surg. 2024 Oct 1;154(4):795e-798e. doi: 10.1097/PRS.0000000000011250. Epub 2023 Dec 22.
Corneal anesthesia, caused by lack of corneal innervation, is a rare but devastating condition that can lead to neurotrophic keratopathy, corneal ulceration, scarring, and blindness. Minimally invasive corneal neurotization enables transfer of regional donor sensory nerves to the cornea to provide sensation and ocular protection. The authors provide an update on technical advances and modifications that have refined the surgery over the past 10 years, as well as step-by-step intraoperative videos of corneal neurotization, noting its critical steps, pitfalls, and caveats. The videos illustrate the novel technique of using the greater auricular nerve with a sural nerve graft extension as the donor nerve for the procedure. The steps and considerations depicted will allow surgeons to carry out corneal neurotization efficiently, safely, and effectively.
由于角膜神经支配缺失导致的角膜麻醉是一种罕见但极具破坏性的病症,可引发神经营养性角膜病变、角膜溃疡、瘢痕形成及失明。微创角膜神经化术能够将区域供体感觉神经转移至角膜,以提供感觉及眼部保护。作者介绍了过去10年中使该手术得以完善的技术进展和改进,以及角膜神经化术的术中分步视频,指出了其关键步骤、陷阱及注意事项。这些视频展示了使用耳大神经并延长腓肠神经移植作为该手术供体神经的新技术。所描述的步骤和注意事项将使外科医生能够高效、安全且有效地实施角膜神经化术。
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