Name

228 - Réinnervation cornéenne par neurotization cornéenne: étude en microscopie confocale

To assess corneal sensation and reinnervation by esthesiometry and confocal microscopy after corneal neurotization to treat neurotrophic keratopathy in a 12-months follow-up.

Corneal neurotization was successfully achieved with the ipsilateral great auricular nerve in 5 patients. Cochet-Bonnet esthesiometry and in vivo confocal microscopy were performed before and after corneal neurotization to follow corneal sensation recovery and corneal reinnervation respectively.

Neurotrophic keratopathies were the result of surgically treated meningioma or neurinoma. Before surgery corneal sensation and corneal innervation were absent. Six months after surgery, confocal microscopy confirmed regrowth of a high number of nerve fibers in the subepithelial space of the cornea. Nine months after surgery, we observed a recovery of corneal sensation.

The use of the great auricular nerve for corneal neurotization may be relevant because of its low associated morbidity and anatomical proximity. Confocal microscopy proved the corneal reinnervation.

Corneal neurotization allows reinnervation of the cornea and recovery of ocular sensation and had opened a new era on the management of neurotrophic keratitis.