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Case Reports
. 2001 Jul;132(1):106-8.
doi: 10.1016/s0002-9394(00)00958-2.

Bilateral neurotrophic keratopathy complicating Vidian neurectomy

P Y Lin  1 , C Y Cheng, C C Wu, M Y Yen, S J Wang, K K Liao, S M Lee
Affiliations
Case Reports

Bilateral neurotrophic keratopathy complicating Vidian neurectomy

P Y Lin et al. Am J Ophthalmol. 2001 Jul.

Abstract

Purpose: To present a case of bilateral neurotrophic keratopathy with miosis after bilateral Vidian neurectomy for vasomotor rhinitis.

Methods: Observational case report.

Results: A 68 year-old man presented with irritation and blurred vision in both eyes 2 weeks after bilateral Vidian neurectomy. Slit-lamp examination revealed a large epithelial defect, typical of neurotrophic keratopathy, in the inferior two-thirds of cornea in both eyes. Corneal sensitivity test with a Cochet-Bonnet anesthesiometer and electrical study of the blink reflex indicated bilateral trigeminal dysfunction. Both pupils were miotic, and tests with hydroxyamphetamine 1% and epinephrine 0.1% showed postganglionic sympathetic nerve damage. The corneal epithelial defects healed after 2 months of treatment with systemic prednisolone, vitamin B(12) and tarsorrhaphy.

Conclusion: Neurotrophic keratopathy associated with dry eye syndrome may be a serious complication of Vidian neurectomy.

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