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Mackie Classification of Neurotrophic Keratitis.




Neurotrophic Keratitis!


- Corneal innervation by the trigeminal nerve (5th cranial nerve) is impaired.

- Partial or complete loss of corneal sensation can result in epithelial keratopathy, epithelial defect, stromal ulceration, and eventually corneal perforation.


TREATMENT: (According to stages of Mackie Classification).

Stage 1:

-Withdrawal of epitheliotoxic drugs, preservative-free lubricating drops, BCL, Oral tetracycline/doxycyline.


Stage 2:

-Preservative-free lubricants and ointment, growth factors, Autologous serum eyedrops, Patching, Tarsorrhaphy.


Stage 3:

-Collagenase inhibitors (tetracycline, Vitamin C).

-Cyanoacrylate glue with BCL.

-Conjunctival Gunderson Flap.

-Amniotic Membrane Grafting.

-Penetrating Keratoplasty.



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