Corneal Neurotization

Description

This patient presented with left-sided CN 5, 6, 7, and 8 palsies leading to multiple emergency visits for corneal erosions and infectious corneal ulcers. Prior treatment was with amniotic membrane discs, superficial keratectomy with EDTA, botox tarsorrhaphy, and a surgical ertractor reinsertion with lateral canthal tendon plication.

The patient then underwent a Corneal Neurotization procedure using an allograft to the contralateral supraorbital nerve. This was performed by Dr. Rong and Dr. Amescua. The surgeons exposes the superior orbital rim through an upper eyelid incision. They identify and dissect the supraorbital nerve, which will be transected. The contralateral upper eyelid incision is then made. The processed nerve allograft is attached to a nerve connector. The supraorbital nerve is fed into the opposite end, forming an end-to-end connection. The graft is then tunneled to the affected side. It is brought to the affected cornea, and the fascicles are inserted into the conjunctiva.

The vision improved from CF to 20/70 and the corneal epithelial defect healed.

Uploaded on: 11/06/2022