Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature

Saad, Sami; Labani, S.; Goemaere, Isabelle; Cuyaubère, Roxane; Borderie, M.; Borderie, Vincent; Benkhatar, Hakim; Bouheraoua, Nacim

doi:10.1016/j.jfo.2022.09.007

Cited by 2 publications

(3 citation statements)

References 36 publications

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“…NK is a rare degenerative disease of the corneal subbasal nerve plexus with an insidious evolution ( 48 ). Its management and accurate diagnosis are challenging due to the diverse underlying ocular and systemic diseases such as dry eye, tear film alteration, limbal stem cell dysfunction, corneal dystrophies, chronic use of topical medications, herpetic infection, and diabetes mellitus ( 49 – 53 ).…”

Section: Discussionmentioning

confidence: 99%

“…The main strategy in stage 1 NK treatment is to improve epithelial quality and stability, accelerate corneal healing, and prevent stromal involvement ( 9 ). NK therapy includes a diverse spectrum such as nerve growth factor (NGF) eye drops, neuropeptides (substance P), surgical therapy, and autologous blood-based eye drops ( 48 , 58 , 59 ). OXERVATE ® (cenegermin-bkbj), an FDA-approved topical recombinant human nerve growth factor, was reported as an efficient therapy in moderate to severe NK that can lead to significant improvement in corneal sensation and complete resolution of epithelial defect ( 60 – 62 ).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Plasma Rich in Growth Factors (PRGF) in Stage 1 Neurotrophic Keratitis

Sabater

Ghalibafan

Osei

et al. 2023

Preprint

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Background/Aims: Neurotrophic keratitis (NK) is a neurodegenerative disease that can lead to corneal hypoesthesia, decreased tear production, and epitheliopathy. Based on the severity of ocular surface damage, NK is classified into 3 stages. Stage 1 NK is characterized by superficial punctate keratopathy, tear film instability, and reduced corneal sensation. The therapeutic efficacy of PRGF eye drops for NK stages 2 and 3 has been previously reported. In this study, we evaluated the efficacy and safety of autologous PRGF eye drops in improving corneal sensitivity and other ocular surface clinical signs in patients with stage 1 NK. Methods: Retrospective chart review Results: 26 eyes of 15 stage 1 NK patients (seven males, eight females), aged 76.3 ± 12.1 years, were included in the study. The mean treatment duration was 2 ± 1.8 months. With PRGF treatment, corneal sensitivity increased from 2.8 to 4.5 cm in 53.8% (14/26) (p < 0.01), TBUT increased from 3.6 to 5.0 s in 69.2% (18/26) (p < 0.01), and Schirmer score increased from 13.7 to 16.8 mm in 80.7% (21/26) of treated eyes (p < 0.01). Similarly, an improvement in corneal staining (punctate epithelial erosions) and MMP-9 levels was seen in 80.7% (n = 21) and 65.4% (n = 17) of treated eyes, respectively. BCVA improvement was seen in 26.9% of treated eyes (n = 7). Conclusions:This study demonstrates the effective role of PRGF therapy in recovering corneal sensation and tear film function and in the healing of corneal erosions in stage 1 NK patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Plasma Rich in Growth Factors (PRGF) in Stage 1 Neurotrophic Keratitis

Sabater

Ghalibafan

Osei

et al. 2023

Preprint

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“…Corneal neurotization can be performed either by directly transferring a nerve from its original position to supply the cornea (direct corneal neurotization, DCN) or by connecting a nerve to the cornea via nerve graft conduit (indirect corneal neurotization, ICN) [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Direct neurotization could perhaps achieve a faster clinical response, while indirect neurotization requires new axons to grow down the length of the nerve graft to the cornea and can take approximately 6 months.…”

Section: Corneal Neurotization—surgical Techniquesmentioning

confidence: 99%

Corneal Neurotization—Indications, Surgical Techniques and Outcomes

Dragnea

Krolo

Koppen

et al. 2023

JCM

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Corneal neurotization is a promising surgical approach for the treatment of moderate to severe neurotrophic keratopathy. This technique aims to restore corneal sensation by transferring healthy nerves, either directly or via a conduit, to the anesthetic cornea. This review provides a report on the current state of development, evidence, and experience in the field. We summarize the data available from clinical reports and case series, placing an emphasis on the diversity of the surgical techniques reported. While these data are encouraging, they also highlight the need for a consensus in reporting outcomes and highlight how the next step will involve validating putative outcome parameters when researching and reporting corneal neurotization surgery.

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Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature

Cited by 2 publications

References 36 publications

Efficacy of Plasma Rich in Growth Factors (PRGF) in Stage 1 Neurotrophic Keratitis

Efficacy of Plasma Rich in Growth Factors (PRGF) in Stage 1 Neurotrophic Keratitis

Corneal Neurotization—Indications, Surgical Techniques and Outcomes

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