METHOD OF RESTORING EYE CORNEA TROPHISM AND SKIN SENSITIVITY IN THE ZONE OF INNERVATION OF THE FIRST BRANCH OF THE TRIGEMINAL NERVE IN NEUROTROPHIC KERATOPATHY Russian patent published in 2023 - IPC A61B17/00 A61F9/11 

FIELD: medicine; maxillofacial surgery; ophthalmology.

SUBSTANCE: coronal incision is made, dissecting the skin and subcutaneous fat along the intended line in the temporo-parietal regions from one ear to the other to the periosteum. The temporo-parietal flap is separated from the periosteum, reaching the superficial plates of the temporal fascia and folded to the front side. The periosteum is dissected, stepping back from the upper orbital edges by 8–11 cm. Then, the periosteum is peeled off from the frontal bone to the upper orbital edges and the bone pyramid of the nose from both sides and thrown back together with the temporo-parietal flap to the front side. On the healthy side, the exit points of the supraorbital and/or supratrochlear nerves from the orbit are visualized and released. On the healthy side, 4–8 branches of the supraorbital and/or supratrochlear nerves are isolated from the temporoparietal flap. Next, the distal end of one of the branches of the supraorbital or supratrochlear nerves on the healthy side is sutured to the majority of the supraorbital nerve on the affected side at the point of its exit from the orbit "end-to-side". Further, on the affected side, in the folded temporoparietal flap, a tunnel is formed from the upper conjunctival fornix of the upper eyelid to the periosteum of the superomedial edge of the orbit. Branches of the supraorbital and/or supratrochlear nerves of the healthy side are conducted from the periosteum of the superomedial edge of the orbit to the superior conjunctival fornix of the upper eyelid of the affected side. The temporoparietal flap is positioned in place. On the affected side, tunnels are formed around the limbus of the cornea for passing the branches of the supraorbital and/or supratrochlear nerves of the healthy side. 3–5 perilimbal incisions are performed of the conjunctiva and Tenon's capsule around the corneal limbus, departing 2–4 mm from it. Next, tunnels are formed in the episcleral space, connecting the incisions to each other. Further, corneoscleral tunnels are formed around the corneal limbus in the sclera at the sites of incisions in the conjunctiva and Tenon's capsule. Parallel to the limbus of the cornea, 3–5 incisions of the sclera, 2–4 mm wide, are made in a layer 1/3–1/2 of its thickness. The tissues of the sclera and cornea are stratified by 1–2 mm in the direction from the limbus to the center of the cornea. Further, from the previously formed tunnel in the temporoparietal flap, ending in the upper conjunctival fornix of the upper eyelid of the affected side, a tunnel is formed under the Tenon's capsule and conjunctiva to the nearest perilimbal incision of the conjunctiva by the method of blunt and sharp dissection. Branches of the supraorbital and/or supratrochlear nerves are pulled in the formed tunnels in the temporoparietal flap and in the episcleral space, divided into fascicules and fixed in the formed corneoscleral tunnels.

EFFECT: method allows restoring the sensitivity of the eye cornea, forehead skin and upper eyelid on the affected side in patients with neurotrophic keratopathy with partial or complete damage to the trigeminal nerve.

1 cl, 3 ex, 1 dwg