RELEVANCE

Damage of the trigeminal and facial nerves leads the protective function of the eyelids is disrupted and neurotrophic keratopathy which can lead the visual loss.

OBJECTIVE

The study the topographic and anatomical features of the donor zone and the functional results of direct corneal neurotization.

MATERIAL AND METHODS

10 direct corneal neurotisations were performed using supraorbital and supratrochlear nerves. The indication for the procedure was a decrease of blink reflex and corneal sensitivity. The effectiveness of the procedure was assessed by the dynamics of sensitivity and photoregistration of the cornea. Donor damage was assessed by the dynamics of skin sensitivity before and after surgery.

RESULTS AND DISCUSSION

3-5 nerve fascicules 6-12 cm long of the supraorbital and supratrochlear nerves were used. Followed-up 4 to 30 months. At the same time, against the background of the absence of relapses of neurotrophic keratopathy, complete recovery was observed in 6 and a significant increase in corneal sensitivity in 4 patients. There was an improvement in the transparency of the cornea, a reduction in the area and intensity of opacities. There was a slight decrease in skin sensitivity was noted on the donor side.

CONCLUSION

Direct corneal neurotization in all patients provided positive dynamics, consisting in restoring corneal sensitivity, reducing the area and intensity of the eyesore, partially restoring the sensitivity of the eyelid skin on the affected side without significant donor damage.

Keywords. facial nerve, paralytic lagophthalmos, diverting nerve, converging paralytic strabismus, neurotrophic keratopathy, corneal innervation, corneal thorn, corneal sensitivity, esthesiometry