title: [Neurotrophic keratitis after vitrectomy and circumferential endophotocoagulation for retinal detachment].
abstract: BACKGROUND
  Circumferential (360°) endophotocoagulation is frequently implemented during vitrectomies for retinal detachment. This photocoagulation may result in neurotrophic keratitis by damaging the ciliary nerves in the suprachoroidal space on their way to the pupil. We report a series of 4 cases of neurotrophic keratitis following a circumferential endophotocoagulation.
  
  
  METHODS
  A retrospective observational case series of 4 non-diabetic patients having presented with a neurotrophic keratitis following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation (532 nm) at Caen University Hospital. We report the various forms of corneal lesions and the diagnostic criteria allowing for the diagnosis of neurotrophic keratitis.
  
  
  CONCLUSIONS
  Neurotrophic keratitis is caused by lesions occurring at various levels of corneal innervation. Endophotocoagulation may cause a neurotrophic keratitis by damaging the short and long ciliary nerves on their way to the pupil in the suprachoroidal space. The sequelae of this condition can limit visual recovery. Hence, it is probably advisable to screen for corneal anesthesia or severe hypesthesia following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation and to implement prophylactic treatment (intensive lubricant therapy; preservative-free eye drops) if needed.
  
  
  CONCLUSIONS
  The risk of neurotrophic keratitis should be weighed against the dose of laser retinopexy necessary and sufficient to obtain a sustained retinal reattachment. If circumferential endophotocoagulation is implemented, it is probably sensible to monitor corneal sensitivity and to adapt postoperative treatment if necessary.
authors.affiliation: Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Auchère Lavayssiere
authors.affiliation: Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
authors.forename: A-L
authors.initials: AL
authors.lastname: Lux
authors.affiliation: Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Degoumois
authors.affiliation: Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Stchepinsky Launay
authors.affiliation: Service ophtalmologie, CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen cedex 9, France. Electronic address: denion-e@chu-caen.fr.
authors.forename: E
authors.initials: E
authors.lastname: Denion
mesh_terms: D000368:Aged; D003315:Cornea / Q000294:innervation / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007634:Keratitis / Q000209:etiology*; D017075:Laser Coagulation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D014821:Vitrectomy / Q000009:adverse effects*
keywords: Aesthesiometry; Ciliary nerves; Circumferential endophotocoagulation; Cornea; Cornée; Décollement de rétine; Endophotocoagulation circonférentielle; Esthésiométrie; Kératite neurotrophique; Nerfs uvéaux; Neurotrophic keratitis; Retinal detachment; Vitrectomie; Vitrectomy