研究目的
To analyze pre- and post-operative corneal changes using in vivo confocal corneal microscopy in a patient with neurotrophic keratitis undergoing corneal neurotization surgery.
研究成果
The study demonstrates that corneal neurotization surgery, evaluated with IVCCM, leads to significant trophic improvements in the cornea, including restoration of the sub-basal nerve plexus and reduction of dendritic cells. IVCCM is a valuable non-invasive tool for pre- and post-operative assessment, supporting its use in clinical practice for such procedures. Future research should involve more cases and longer follow-up to validate these findings.
研究不足
The study is limited to a single case, which may not be generalizable. The use of IVCCM is non-invasive but relies on qualitative image analysis, and long-term outcomes beyond 24 weeks were not assessed. Potential areas for optimization include larger sample sizes and quantitative metrics for nerve regeneration.
1：Experimental Design and Method Selection:
A case study design was employed, utilizing in vivo confocal corneal microscopy (IVCCM) to evaluate corneal changes before and after corneal neurotization surgery. The surgical procedure involved a termino-terminal anastomosis between the contralateral supraorbital nerve and the affected cornea using a sural nerve graft.
2：Sample Selection and Data Sources:
The sample was a single 14-year-old female patient with neurotrophic keratitis due to trigeminal anaesthesia from a pontine cavernoma. Data were collected from clinical examinations and IVCCM imaging.
3：List of Experimental Equipment and Materials:
Equipment included the HRTII/Rostock Corneal Module for IVCCM. Materials included surgical instruments for nerve grafting, such as sutures, and the sural nerve graft harvested from the patient's leg.
4：Experimental Procedures and Operational Workflow:
Preoperative IVCCM was performed to assess corneal status. Surgery involved sectioning the right supraorbital nerve, harvesting the sural nerve graft, and distributing it around the perilimbal subconjunctival space of the left eye. Postoperative IVCCM evaluations were conducted at weeks 4, 8, and 24 to monitor changes.
5：Data Analysis Methods:
Qualitative analysis of IVCCM images was used to observe changes in corneal structures, including nerve plexus, epithelium, stroma, endothelium, and dendritic cells. Clinical improvements were also noted subjectively.
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