Neuroparalytic Keratitis and the Effect of Cervical Sympathectomy following Operative Procedures for Trigeminal Neuralgia

Abstract

A study of 248 patients who underwent operative procedures for trigeminal neuralgia over a nineteen year period is presented, with particular reference to those who developed neuroparalytic keratitis to see if cervical sympathectomy had any protective effect on the cornea. 51 patients underwent cervical sympathectomy, 46 as a prophylactic procedure, and 5 as a treatment for neuroparalytic keratitis. Of these patients 3 (5.9%) developed neuroparalytic keratitis, but 2 of them had had an inadequate sympathectomy. Forty seven patients who did not undergo cervical sympathectomy had either an anaesthetic cornea or a reduced corneal reflex, and of these 11 (23.4%) developed neuroparalytic keratitis. An adequate cervical sympathectomy therefore appears to have a protective effect on the cornea against the development of neuroparalytic keratitis.