A single centre, prospective, non-randomised, non-comparative interventional case series investigating the efficacy of direct corneal neurotization using supraorbital and supratrochlear nerves in patients with anaesthetic cornea.

To evaluate the efficacy of direct corneal neurotization using supraorbital and supratrochlear nerves in patients with anaesthetic cornea. Through a bicoronal incision, the supratrochlear and supraorbital nerves will be identified and carefully dissected under high magnification. The nerve branches will then be tunnelled over the nasal bridge to a small incision along the lid crease of the upper lid of the contralateral anaesthetic eye. Under the operating microscope, the distal nerve branches will be retrieved with a fine hemostat inserted through a tiny incision under the upper lid. The eye will then be directed downward using a superior rectus tendon traction suture. An incision through the superior bulbar conjunctiva 7mm behind the superonasal position of the corneal limbus will be made. In the potential space between where the sclera and Tenon’s capsule are juxtaposed to the anatomical corneal limbus, a tunnel will be created by blunt dissection using curved scissors around the circumference of the corneal limbus both temporally and nasally to the points of planned insertion of the prepared nerves. The distal nerve branches will be passed into the prepared perilimbal space, fanned and sutured into place in the conjunctival sac next to the corneal limbus with 10-0 monofilament nylon sutures under direct high magnification. The overall surgery time will be approximately 45 minutes.