Interventional procedure overview of nerve graft for corneal denervation
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Summary of key evidence on autograft: sural nerve graft with great auricular nerve as donor for corneal denervation
Study 5 Jowett N (2019)
Study type | Single arm, single centre, non-randomised, prospective, case series |
|---|---|
Country | USA |
Recruitment period | 2017 |
Study population and number | n=2 eyes in 2 people Adults with neurotrophic keratitis |
Age and sex | 28 and 31 years old; 100% male |
Patient selection criteria | People with grade 3 neurotrophic keratitis. |
Technique | Sural nerve graft coapted to the ipsilateral great auricular nerve. Scleral-corneal tunnel incisions were used to expedite neurotisation of the corneal stroma. Fibrin glue and 10-0 Nylon sutures were used to coapt the nerve. A temporary lateral suture tarsorrhaphy was placed after surgery. |
Follow up | 6 to 8 months |
Conflict of interest/source of funding | Conflict of interest: the authors declared that they have no conflicts of interest. Source of funding: the authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors. |
Analysis
Study design issues: This single arm, single centre, non-randomised, prospective, case series reported a novel corneal neurotisation technique to treat neurotrophic keratitis. Outcomes included corneal sensation, as measured by Cochet-Bonnet aesthesiometry, and BCVA.
No statistical analysis was described.
Key efficacy findings
Number of people analysed: 2 eyes in 2 people
Follow up at time of assessment: 6 to 8 months
Both people had improved corneal sensation and BCVA at final follow up.
Person | Corneal sensation | BCVA | ||||
Before surgery | Follow up | After surgery | Before surgery | Follow up | After surgery | |
1 | Absent | 8 months | 47 mm | 20/125 | 4.5 months | 20/80 |
2 | 0 to 15 mm | 5.5 months | 37 mm | 20/300 | 5.5 months | 20/80 |
Abbreviations: BCVA, best-corrected visual acuity.
Key safety findings
One person noted referred sensations to the ipsilateral earlobe. This was relieved by ocular irrigation.
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