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Long-term corneal neurotization impacts on visual acuity and sensation in the treatment of neurotrophic keratopathy
Jordan R Crabtree BS, Khoa Tran MPH, Sara Williams MSc, Arif Hussain MD, Konstantin Feinberg PhD, Asim Ali MD, Gregory H Borschel MD
Indiana University School of Medicine
2025-01-10
Presenter: Jordan R Crabtree
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The work was completed by IU personnel, primarily the presenting author, with data contributions form SickKids Children's Hospital in Toronto.
Director Name: William A. Wooden, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Neurotrophic Keratopathy (NK) results from insufficient corneal innervation, leading to the loss of corneal sensation and protective reflexes, injury, and permanent vision loss. Corneal neurotization (CN) provides corneal innervation by conducting sensory donor nerve fibers into denervated corneas. However, despite being the only definitive treatment of NK, limited data is available regarding long-term clinical outcomes.
This retrospective study included 13 patients who underwent CN with at least six years of follow-up (n=16 eyes) from the Corneal Neurotization Assessment Registry, established by the Hospital for Sick Children and Indiana University. Corneal sensation was assessed by monofilament testing using Cochet-Bonnet (CB) aesthesiometry in five regions, and descriptive statistics were used to describe demographics and clinical outcomes. The maximum reported sensation value for each visit was analyzed. Visual acuity was standardized through conversion to logMAR scores. Linear mixed models were used to assess changes in corneal sensation and visual acuity over time in GraphPad PRISM.
Mean CB values at preoperative baseline, five-year, and six-year follow-up were 1.0 mm (SD=2.24), 43.8mm (SD=13.77), and 46.7mm (SD=20.21), respectively. Statistically significant differences in sensation were found at both five (p<0.0001), and six years (p=0.001). Mean LogMAR values were found to be 0.84 (SD=0.51) preoperatively, 0.89 (SD=0.48) at 5 years, and 0.50 (SD=0.37) at 6 years. No significant difference was found between preoperative and postoperative LogMAR values.
We observed that sensory gains in corneal sensation following CN remain high even after six years. CN prevented the decline in visual acuity that is otherwise inevitable in patients with NK.
