Minimally-Invasive Corneal Neurotization (MICN): 10 Year Update in Technique and Lessons Learned Including Novel Donor Transfer of the Great Auricular Nerve.

ABSTRACT

VIDEO PLUS SUBMISSION SUMMARY: Corneal anesthesia, caused by lack of corneal innervation, is a rare but devastating condition that can lead to neurotrophic keratopathy 1, corneal ulceration, scarring, and blindness. Minimally-Invasive Corneal Neurotization (MICN) enables transfer of regional donor sensory nerves to the cornea to provide sensation and ocular protection. Here, we provide an update on technical advances and modifications that have arisen over ten years that have refined the surgery. We provide intraoperative step by step videos of corneal neurotization, noting its critical steps, pitfalls, and caveats. This video submission will focus on the novel technique of utilizing the greater auricular nerve with a sural nerve graft extension as the donor nerve for the procedure. The steps and considerations depicted will allow surgeons to carry out corneal neurotization efficiently, safely, and effectively.