Interventional procedure overview of nerve graft for corneal denervation
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Summary of key evidence on autograft: great auricular nerve graft with orbital nerves as donor for corneal denervation
Study 6 Benkhatar H (2018)
Study type | Case report |
|---|---|
Country | France |
Recruitment period | Not reported |
Study population and number | n=1 eye in 1 person Adult with neurotrophic keratitis. |
Age and sex | 58 years old; female |
Patient selection criteria | Not reported |
Technique | Great auricular nerve graft end-to-end coapted to the contralateral supratrochlear nerve. Each fascicle was secured under the conjunctiva with 10-0 Nylon sutures around the cornea. The procedure ended with lateral tarsorrhaphy. |
Follow up | 12 months |
Conflict of interest/source of funding | Conflict of interest: the authors declare no conflict of interest. Source of funding: the authors declare no source of funding. |
Analysis
Study design issues: This case report described the first use of corneal neurotisation using a great auricular nerve graft to treat neurotrophic keratitis. Outcomes included corneal sensation (measured by Cochet-Bonnet aesthesiometry), corneal innervation (measured by confocal microscopy), and an assessment of the status of the corneal epithelium (measured by slit-lamp examination).
Key efficacy findings
Number of people analysed: 1 eye in 1 person
Follow up at time of assessment: up to 12 months
Assessment time | Corneal sensation (aesthesiometry) | BCVA | Slit-lamp examination (corneal appearance) | Confocal microscopy findings (corneal innervation) |
Before surgery | Absence of sensation | Below 20/200 | - | Absence of nerve fibres |
3 month follow up | Absence of sensation | Not reported | Not reported | Clear nerve regeneration through the corneal subbasal and stromal layers |
6 month follow up | Absence of sensation | Below 20/200 | No improvement in corneal appearance | Nerve fibres were present at high density in both nasal and temporal sectors |
9 month follow up | 10 mm | Not reported | Not reported | Not reported |
12 month follow up | 10 mm | Not reported | No improvement in corneal appearance | Not reported |
Abbreviations: BCVA, best-corrected visual acuity.
Key safety findings
Number of people analysed: 1 eye in 1 person
Follow up at time of assessment: 12 months
Mild paraesthesia of the earlobe, n=1
Progressively resolved over a period of 6 months.
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