Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Dr R P Centre for Ophthalmic Sciences - Cornea and Ocular Surface, Cataract and Refractive Services, All India Institute of Medical Sciences, New Delhi, India.
Indian J Ophthalmol. 2024 Oct 1;72(10):1404-1411. doi: 10.4103/IJO.IJO_195_24. Epub 2024 Sep 27.
This study aimed to comprehensively explore the intricacies of corneal neurotization (CN) and the nuanced factors that set it apart from routine clinical practice, exerting a substantial influence on its success. A symbiotic relationship is evident between corneal innervation and ocular surface health. The loss of corneal innervation results in a potentially challenging corneal condition known as neurotrophic keratopathy (NK). The majority of treatments are primarily focused on preventing epithelial breakdown rather than addressing the underlying pathogenesis. Consequently, to address the impaired corneal sensation (underlying etiology), a novel surgical approach has emerged, namely CN, which involves transferring healthy sensory nerve axons to the affected cornea. This review offers valuable insights into the existing body of supporting evidence for CN, meticulously examining clinical studies, case reports, and experimental findings. The aim is to enhance our understanding of the effectiveness and potential outcomes associated with this innovative surgical technique. The exploration of innovative therapeutic avenues holds promise for revolutionizing the management of NK, offering a potentially permanent solution to a condition once deemed incurable and severely debilitating.
本研究旨在全面探讨角膜神经化（CN）的复杂性，以及将其与常规临床实践区分开来的细微因素，这些因素对其成功有重大影响。角膜神经支配与眼表面健康之间存在着共生关系。角膜神经支配的丧失会导致一种潜在的挑战性角膜疾病，即神经营养性角膜病变（NK）。大多数治疗方法主要集中在预防上皮破裂，而不是解决潜在的发病机制。因此，为了解决受损的角膜感觉（潜在病因），出现了一种新的手术方法，即 CN，它涉及将健康的感觉神经轴突转移到受影响的角膜。这篇综述提供了对 CN 现有支持证据的宝贵见解，详细检查了临床研究、病例报告和实验发现。目的是增强我们对这种创新手术技术的有效性和潜在结果的理解。探索创新的治疗途径有望彻底改变 NK 的治疗方法，为曾经被认为是无法治愈且严重致残的疾病提供一种潜在的永久性解决方案。
