Neuroparalytic or """"""""neurotrophic"""""""" keratitis is a serious complication of both intracranial neurosurgical ablative procedures and percutaneous radiofrequency lesions directed at alleviating the intense pain of trigeminal neuralgia. These procedures are directed at destroying trigeminal ganglion cells or transecting the fifth cranial nerve. Chronic corneal clouding is also observed as a consequence of infectious invasion and destruction of trigeminal ganglion cells. In a pilot study we have examined two animal models of neuroparalytic keratitis: One as a result of trigeminal nerve transection and the other as a consequence of systemic administration of capsaicin (a drug known to destroy small sized sensory fibers and associated neurons) to neonatal rats. Corneal wound healing is abnormal in both of these conditions. During this pilot study we have also developed techniques to innervate corneas in adult rats using anterior chamber transplants of neonatal trigeminal ganglia. The purpose of the present study is threefold. We first propose to fully evaluate the pattern of innervation of normal corneas from transplanted ganglia. We then plan to measure wound healing rates in corneas solely innervated by transplanted ganglia. As a final step,, intraocular grafts will be placed into animals with neuroparalytic keratitis in an attempt to alter the course of this process. By learning more about nerve-cornea interactions, we hope to develop some insight into possible new therapeutic strategies in the management of neuroparalytic keratitis in patients.
| Borges, L F; Zervas, N T; Lehrich, J R (1995) Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard syndrome--case report. Neurosurgery 36:1028-32;discussion 1032-3 |
| Borges, L F (1993) Thompson-Farley spinal retraction system. Neurosurgery 33:160-3 |
