Dokument: Corneal Neurotization in Elderly Patients with Multimorbidity

Titel:Corneal Neurotization in Elderly Patients with Multimorbidity
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=72136
URN (NBN):urn:nbn:de:hbz:061-20260203-124501-2
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Holtmann, Christoph [Autor]
Roth, Mathias [Autor]
Beseoglu, Kerim [Autor]
Borrelli, Maria [Autor]
Geerling, Gerd [Autor]
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Dateien vom 03.02.2026 / geändert 03.02.2026
Stichwörter:neurotization , neurotrophic , outcome , multimorbidity , keratopathy
Beschreibung:Purpose

Corneal neurotization (CN) is a surgical technique to improve corneal sensitivity and the ocular surface in eyes with neurotrophic keratopathy. It has been predominantly advocated in patients with congenital corneal hypesthesia. Neurotrophic keratopathy is however much more frequent at an older age and in often multimorbid patients. We report our experience with corneal neurotization in patients with multimorbidity.
Methods

Seven eyes of 5 patients (f:m = 2:3, median age 70 ± 12 years) suffering from neurotrophic keratopathy due to Diabetes mellitus (n = 3), post Herpes Zoster keratitis (1) and drug use (1) were treated with direct CN using the supraorbital nerve (n = 5) or indirect CN (n = 2, with sural nerve interponate) and followed for a median of 7 months. In one case, a femtosecond laser was used to create peripheral intrastromal corneal pockets. Documented parameters included corneal sensitivity tested with a Cochet Bonnet aesthesiometer in four quadrants and the corneal center pre- and postoperatively, stage of NK, and duration of surgery.
Results

Corneal sensitivity was 0 mm in all areas tested of all corneas prior to neurotization (stage 3 NK). Mean surgical time was 247 ± 53 min. At 3 months, it was improved in 63% of all areas tested (5/7 eyes). In two eyes, severe neurotrophic keratopathy recurred (stage 3 NK). Three out of the five patients died of general conditions during follow-up.
Conclusion

Corneal neurotization is a resource intensive technique, which successfully can improve corneal sensitivity. We also for the first time used a femtosecond laser to create peripheral intrastromal corneal pockets. When offering CN to elderly patients the long time to more profound corneal reinnervation, required to prevent corneal perforation, and generally potential fatal comorbidities should be considered carefully. Given the good results reported for younger patients the procedure should be indicated probably earlier in the course of the disease.
Rechtliche Vermerke:Originalveröffentlichung:
Holtmann, C., Roth, M., Beseoglu, K., Borrelli, M., & Geerling, Gerd . (2025). Corneal Neurotization in Elderly Patients with Multimorbidity. Current Eye Research, 50(9), 886–893. https://doi.org/10.1080/02713683.2025.2509567
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:03.02.2026
Dateien geändert am:03.02.2026
english
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