ESCRS - PP26.10 - Clinical Assessment Of Neurotized Patients Who Received Corneal Graft - A Case Series

Clinical Assessment Of Neurotized Patients Who Received Corneal Graft - A Case Series

Published 2023 - 41st Congress of the ESCRS

Reference: PP26.10 | DOI: 10.82333/cwwm-8x90

Authors: Alfonso Strianese 1 , Valentino De Ruvo* 1 , Federico Bolognesi 2 , Massimo Busin 3 , Luca Mario Rossetti 1 , Federico Biglioli 2 , Giuseppe Giannaccare 4 , Paolo Fogagnolo 1 , Italian Neurotization Study group . 5

1Ophthalmology,San Paolo Hospital ,Milan,Italy, 2Maxillo Facial Surgery,San Paolo Hospital ,Milan,Italy, 3Ophthalmology,Ospedali Privati - Villa Igea,Forlì,Italy, 4Ophthalmology,Università Magna Graecia,Catanzaro,Italy, 5Ophthalmology,San Paolo Hospital ,Milan,Italy;Ophthalmology,Università Magna Graecia,Milan,Italy;Ophthalmology,Ospedali Privati - Villa Igea,Milan,Italy;Ophthalmology,Luigi Sacco Hospital,Milan,Italy;Maxillo Facial Surgery,San Paolo Hospital ,Milan,Italy;Ophthalmology,S.Orsola-Malpighi Hospital,Bologna,Italy;Ophthalmology,Santa Maria alle Scotte Hospital,Siena,Italy

Corneal neurotization (CN) has been recently introduced as a potentially curative surgical procedure in the setting of NK. Despite the good results obtained after this kind of surgery is not uncommon for those patients to require further surgical intervention like perforant (PK) or anterior lamellar (DALK) keratoplasty. The poster aims at reviewing the indications of corneal graft of neurotized patient who underrwent corneal transplant and to describe both clinical and in vivo confocal microscopy (IVCM) findings at the longest follow-up.

Spontaneous, Cross-sectional, Multicentric study (ASST Santi Paolo e Carlo Hospital, University of Milan; S.Orsola-Malpighi Hospital, University of Bologna; Santa Maria alle Scotte Hospital, University of Siena, Italy, Ospedali Privati Forlì, Villa Igea).

We reviewed the cohort of patients who received CN from November 2014 to October 2019 in 3 Italian tertiary cornea centers and selected the ones who underwent corneal graft.

After recovery of corneal sensation, four patients received corneal grafts to improve visual acuity (three PK, one DALK) . Follow-up was 6.25 ± 2.63 years. Visual acuity improved in three of four cases. During follow-up, all patients experienced complications: persistent epithelial defect (PED) in three cases (two requiring further surgery), and corneal decompensation in one case. As expected PED recurrence was the most challenging clinical task to manage. Autologous serum was found to be effective in two cases over three. In this series, Cenegermin was not used. IVCM data will be provided.

Corneal graft after CN is a viable strategy to improve visual acuity in selected cases. Yet clinicians should be aware of the increased risk of iatrogenic corneal anesthesia, PED, and ocular surface inflammation whose management may be very challenging.