Corneal Neurotization

Corneal neurotization is a surgical procedure that restores corneal sensation to the eye and treats the numbness of the eye. Patients suffering from neurotrophic kerapathy or nerve damage from injury or surgery to the corneal should consider receiving corneal neurotization as a treatment. Corneal sensation is crucial for the eye, as it is required for blinking and reflex tearing. Corneal neurotization is an outpatient surgery that can be executed under monitored anesthesia care. This procedure is done with the collaboration of the plastic surgeon and ophthalmologist. There are two ways in which this procedure can be done, an indirect corneal neurotization and a direct one. 

In an indirect corneal neurotization, a small nerve graft, often the sural nerve from the lower leg, is harvested and placed near the cornea. Then, it will be connected to a healthy nerve on the opposite side of the face. Over time, new nerve fibers will grow from the transplanted nerve into the cornea, restoring sensation. In a direct corneal neurotization, a healthy sensory nerve will be moved from the unaffected forehead to the affected cornea. Surgeons will then connect this nerve to the cornea, allowing for regrowth to occur. 

Sensation will usually return within six to eighteen months after surgery, but full recovery of corneal nerve function might take longer. The nerve regrowth will begin to occur right after surgery and will take several months to reach the cornea. Initial sensation includes dryness and discomfort of the eye, which marks the beginning of protective blind reflex and increased tear production. 

Corneal neurotization is a revolutionary procedure because it is the first treatment to address the root cause of neurotrophic keratopathy, a degenerative disease that can lead to blindness. Not only does this treatment help manage the symptoms of a numb cornea, this surgery restores protective sensation by supplying nerves to the eye and preventing permanent vision damage. Previous versions of treatments for the disease have been very invasive and not practical. Corneal neurotization opened new doors for treating complex eye conditions and giving patients who suffer from eye damage more options for treatment.

Written by Anna Zheng at Incisionary

References

A pioneering surgery for neurotrophic keratitis. (2025, April 28). Northwell.edu; Northwell Health. https://www.northwell.edu/news/insights/a-pioneering-surgery-for-neurotrophic-keratitis

Corneal neurotization - UF health. (2015). Ufhealth.org. https://ufhealth.org/conditions-and-treatments/corneal-neurotization

Corneal neurotization – restoring corneal sensation | north american society of academic orbital surgeons. (2020). Nasaos.org. https://nasaos.org/corneal-neurotization-restoring-corneal-sensation/