Minimally Invasive Corneal Neurotization Provides Sensory Function, Protects Against Recurrent Ulceration, and Improves Visual Acuity.

center dot PURPOSE: To measure sensory recovery after minimally invasive corneal neurotization, and to identify and quantify the extent to which patient and technical factors influence sensory recovery, ulceration rate, and visual outcomes. center dot DESIGN: Retrospective case series. center dot METHODS: This study included 23 patients with neurotrophic keratopathy who underwent indirect corneal neurotization. The primary outcome measure was corneal and the secondary outcome measure was epithelial breakdown. center dot RESULTS: Over a 7-year period, 28 eyes of 23 patients (mean age, 15.6 +/- 13.6 years) were included in the study. The CBA measurements improved from 3.5 +/- 9.1 mm at baseline to 44.1 +/- 18.2 mm at 24 months after surgery ( P < .001). Maximum CBA was reached after 11.1 +/- 6.2 months (median, 9 months). Compared to eyes neurotized with a contralateral donor nerve, eyes with an ipsilateral donor nerve achieved a higher mean CBA (36.0 +/- 10.9 vs 10.4 +/- 14.0 mm, P = .001) at 3 months. Both the number of fascicles (Spearman correlation coefficient, r s -0.474, P = .11) and insertions ( r s -0.458, P = .014) negatively correlated with the final CBA. Nine eyes (32.1%) experienced at least 1 episode of epithelial breakdown after surgery. Visual acuity improved in the neurotized corneas from logMAR 0.57 +/- 0.79 at baseline to 0.39 +/- 0.66 at 12 months ( P = .043).