Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis

Abstract Objective This study investigated the efficacy of corneal neurotization (CN) surgery for treating neurotrophic keratitis (NK) and evaluated potential factors affecting treatment outcomes. Methods Literature databases were searched from the inception to January 2024 for retrospective or pros...

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Main Authors: Rui Kuang, Shuqia Xu, Xunxun Lin, Bo He, Yangbin Xu, Zhaowei Zhu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02992-8
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author Rui Kuang
Shuqia Xu
Xunxun Lin
Bo He
Yangbin Xu
Zhaowei Zhu
author_facet Rui Kuang
Shuqia Xu
Xunxun Lin
Bo He
Yangbin Xu
Zhaowei Zhu
author_sort Rui Kuang
collection DOAJ
description Abstract Objective This study investigated the efficacy of corneal neurotization (CN) surgery for treating neurotrophic keratitis (NK) and evaluated potential factors affecting treatment outcomes. Methods Literature databases were searched from the inception to January 2024 for retrospective or prospective studies related to corneal neurotization for NK treatment. Data analysis was performed using SPSS 26.0, including analysis of variance, rank sum tests, and multiple regression analysis to determine the efficacy of CN and the impact of patients’ age, gender, surgical method, and etiology on surgical outcomes. Results A total of 14 retrospective or prospective studies were included, comprising 191 patients who underwent CN for neurotrophic corneal lesions. CN significantly improved Mackie staging, logMAR visual acuity, and corneal sensation in patients with congenital and acquired NK (p < 0.0001). In young patients (≤ 30 years), improvement in central corneal sensation was more pronounced (p < 0.05), while elder patients (> 30 years) showed more significant visual acuity improvement (p < 0.05). Multiple linear regression analysis also showed that age was associated with the postoperative improvement in logMAR visual acuity: the elder the patients, the more improvement in visual acuity (p < 0.05). Compared to direct corneal neurotization (DCN), indirect corneal neurotization (ICN) showed more significant improvement in central corneal sensation (p < 0.01). And the patients with congenital NK got more improvement of central corneal sensation after CN by comparison with the others with acquired etiologies (p < 0.001). Multiple linear regression analysis suggested that congenital etiology was associated with more significant postoperative improvement in corneal sensation (p < 0.05). Conclusion CN surgery significantly improves visual acuity, NK Mackie staging, and corneal sensation in NK patients. Age, etiology, and surgical technique may significantly influence treatment outcomes.
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spelling doaj-art-2f84bc184ffd4cf391164c674bf0d9f52025-08-20T03:42:44ZengBMCEuropean Journal of Medical Research2047-783X2025-08-0130111210.1186/s40001-025-02992-8Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitisRui Kuang0Shuqia Xu1Xunxun Lin2Bo He3Yangbin Xu4Zhaowei Zhu5Department of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityOrthopaedic Trauma and Joint Department, Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Plastic Surgery, The First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Objective This study investigated the efficacy of corneal neurotization (CN) surgery for treating neurotrophic keratitis (NK) and evaluated potential factors affecting treatment outcomes. Methods Literature databases were searched from the inception to January 2024 for retrospective or prospective studies related to corneal neurotization for NK treatment. Data analysis was performed using SPSS 26.0, including analysis of variance, rank sum tests, and multiple regression analysis to determine the efficacy of CN and the impact of patients’ age, gender, surgical method, and etiology on surgical outcomes. Results A total of 14 retrospective or prospective studies were included, comprising 191 patients who underwent CN for neurotrophic corneal lesions. CN significantly improved Mackie staging, logMAR visual acuity, and corneal sensation in patients with congenital and acquired NK (p < 0.0001). In young patients (≤ 30 years), improvement in central corneal sensation was more pronounced (p < 0.05), while elder patients (> 30 years) showed more significant visual acuity improvement (p < 0.05). Multiple linear regression analysis also showed that age was associated with the postoperative improvement in logMAR visual acuity: the elder the patients, the more improvement in visual acuity (p < 0.05). Compared to direct corneal neurotization (DCN), indirect corneal neurotization (ICN) showed more significant improvement in central corneal sensation (p < 0.01). And the patients with congenital NK got more improvement of central corneal sensation after CN by comparison with the others with acquired etiologies (p < 0.001). Multiple linear regression analysis suggested that congenital etiology was associated with more significant postoperative improvement in corneal sensation (p < 0.05). Conclusion CN surgery significantly improves visual acuity, NK Mackie staging, and corneal sensation in NK patients. Age, etiology, and surgical technique may significantly influence treatment outcomes.https://doi.org/10.1186/s40001-025-02992-8Corneal neurotizationNeurotrophic keratitisCorneal sensationCorneal nerve transplantation
spellingShingle Rui Kuang
Shuqia Xu
Xunxun Lin
Bo He
Yangbin Xu
Zhaowei Zhu
Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
European Journal of Medical Research
Corneal neurotization
Neurotrophic keratitis
Corneal sensation
Corneal nerve transplantation
title Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
title_full Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
title_fullStr Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
title_full_unstemmed Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
title_short Systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
title_sort systematic analysis of factors affecting the efficacy of corneal reinnervation surgery in treating neurotrophic keratitis
topic Corneal neurotization
Neurotrophic keratitis
Corneal sensation
Corneal nerve transplantation
url https://doi.org/10.1186/s40001-025-02992-8
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