{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:31:10Z","timestamp":1787668270211,"version":"build-2736575974"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T00:00:00Z","timestamp":1701129600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To evaluate the efficacy of corneal neurotisation using sural nerve graft coaptation of the contralateral supratrochlear nerve in unilateral neurotrophic keratopathy and corneal anesthesia. Corneal neuralization has emerged as a potential option in the treatment of neurotropic keratopathy, however not free from the predicament. We evaluated the long-term outcome of corneal neurotisation in the treatment of unresponsive unilateral neurotropic keratopathy using surgical variations to mimic and expedient the surgical procedure.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A Prospective interventional study involving patients with unilateral neurotrophic keratopathy (NK) who did not respond to medical measures was conducted. The study parameters evaluated were best-corrected visual acuity improvement, ocular surface evaluation parameters [tear break-up time (TBUT), Schirmer\u2019s 1, and ocular surface staining scores (corneal and conjunctival staining)], central corneal sensation (Cochet Bonnet esthesiometer), sub-basal nerve fiber length (SBNFL), and sub-basal nerve fiber density (SBNFD) determined by central confocal microscopy at recruitment and during follow-up at 1-month, 3-month, 6-month, 9-month and 12-month respectively, following corneal neurotization.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Eleven eyes of 11 patients with unilateral neurotrophic keratopathy (NK) who underwent corneal neurotisation were studied. The mean follow-up was 10.09\u00b12.31months (range, 6\u201312). Mean best corrected visual acuity in log MAR at baseline, 1.35\u00b10.52 improved significantly to 1.06\u00b10.76 (P = 0.012) at 3 months and continued to 0.55\u00b10.60 (P = 0.027) at 12 months. There was a significant reduction in NK grade severity and improvement in the ocular surface as early as 1 month, and central corneal sensations (P = 0.024) as soon as 3 months. Mean corneal SBNF improved from 3.12\u00b11.84 mm\/mm2 to 4.49\u00b11.88 at 1 month (P = 0.008), 13.31\u00b13.61 mm\/mm2 (P = 0.028) at 12 months. Mean central corneal SBNFD evident at 6 months was 1.83\u00b12.54no\/mm2 (P = 0.018) and 4.90\u00b13.12no\/mm2 (P = 0.028) at 12 months.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study substantiates the routine practice of corneal neurotisation by simplifying the intricacies observed during the procedure.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0294756","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T18:44:33Z","timestamp":1701197073000},"page":"e0294756","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Clinical outcomes of corneal neurotization using sural nerve graft in neurotrophic keratopathy"],"prefix":"10.1371","volume":"18","author":[{"given":"Manu","family":"Saini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman","family":"Kalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5277-3556","authenticated-orcid":true,"given":"Arun K.","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Gaba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chintan","family":"Malhotra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvi","family":"Soni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kulbhushan","family":"Saini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul Chawla","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"key":"pone.0294756.ref001","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/00003226-199603000-00005","article-title":"Aqueous tear production in patients with neurotrophic keratitis","volume":"15","author":"TJ Heigle","year":"1996","journal-title":"Cornea"},{"key":"pone.0294756.ref002","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1167\/iovs.11-8438","article-title":"Dependence of corneal stem\/ progenitor cells on ocular surface innervation","volume":"53","author":"H Ueno","year":"2012","journal-title":"Inves Ophthalmol Vis Sci"},{"key":"pone.0294756.ref003","first-page":"137","article-title":"Trigeminal ganglion neurons affect corneal 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