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ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2025

Long-term outcomes of sural nerve vertical cross-face graft for lacrimal gland neurotization in neurodeprivative dry eye.

Alfonso Strianese, Federico Bolognesi, Giuseppe Giannaccare, Valentino de Ruvo, Fabiana Allevi, Filippo Tarabbia, Luca Mario Rossetti, Federico Biglioli, Paolo Fogagnolo

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Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Neurotrophic keratopathy patients after minimally invasive corneal neurotization treated with RhNGF eyedrops: a case series.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Alfonso StrianeseEye Clinic, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Federico BolognesiUnit of Maxillofacial Surgery, Head and Neck Department, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Giuseppe GiannaccareDepartment of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy. giuseppe.giannaccare@unica.it.ORCID http://orcid.org/0000-0003-2617-0289
Valentino de RuvoDepartment of Ophthalmology, Ospedali Privati Forlì ''Villa Igea'', Forlì, Italy.
Fabiana AlleviUnit of Maxillofacial Surgery, Head and Neck Department, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Filippo TarabbiaUnit of Maxillofacial Surgery, Head and Neck Department, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Luca Mario RossettiEye Clinic, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Federico BiglioliUnit of Maxillofacial Surgery, Head and Neck Department, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.
Paolo FogagnoloEye Clinic, ASST Santi Paolo E Carlo Hospital, University of Milan, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe recently described a novel surgical procedure to reinnervate the lacrimal gland in neurodeprivative dry eye disease and reported the 1-year outcomes of patients treated accordingly. The purpose of this paper is to describe the long-term outcomes of this innovative surgical technique.

methodsMonocentric cross-sectional study including consecutive patients affected by facial palsy with an absolute deficiency of tear secretion (Schirmer test 0 mm/5 min) who underwent lacrimal gland neurotization, as previously described. Before surgery (T0) and at the last follow-up visit (T1), the following parameters were evaluated: tear film break-up time (TBUT), corneal fluorescein staining (Oxford score), Schirmer test type I, usage of tear substitutes (daily number of instillation). At T1, subjective satisfaction with surgery was collected and tear film osmolarity (TFO) was measured in both operated and contralateral eye. Corneal sensitivity was performed at T0 and T1 in patients who underwent neurotization of both lacrimal gland and cornea due to the concomitant presence of neurotrophic keratopathy (trigeminal nerve palsy).

resultsData from 9 patients (4 M, 5 F; mean age 47.1 ± 17.1 years) who underwent lacrimal gland neurotization and were followed up for an average time of 87 months (± 15) (range 60-108) were analyzed. The study procedure was combined in all cases with facial reanimation, while corneal neurotization was performed in 4 cases. At T1, the mean value of Schirmer test was significantly higher compared to T0 (5.8 ± 2.0 vs 0 ± 0 mm/5 min; p < 0.0001). TBUT and corneal fluorescein staining were significantly better compared to baseline (respectively, 2.4 ± 1.8 vs 1.2 ± 0.6 s, p = 0.04 and 1.7 ± 0.8 vs 3.1 ± 0.6, p = 0.0004). TFO was not significantly different between operated eye and contralateral one (306.7 ± 9.5 mOsm/L vs 308.9 ± 11.3 mOsm/L, p = 0.67). The mean daily number of tear substitute instillations was lower at T1 compared to T0 (12 ± 7 vs 21.8 ± 4.3; p = 0.011). Overall, all patients were satisfied with surgery at T1 (very satisfied: n = 3 and satisfied: n = 6). No major postoperative complications were recorded throughout the entire follow-up.

conclusionLacrimal gland neurotization through the sural nerve is a safe and effective procedure with stable favorable outcomes in the long term.

Indexed as

Dry Eye SyndromesLacrimal ApparatusNerve TransferOphthalmologic Surgical ProceduresSural NerveAdultAgedCross-Sectional StudiesFemaleFollow-Up StudiesHumansMaleMiddle AgedRetrospective StudiesTearsTime FactorsDry eyeFacial nerve palsyLacrimal gland neurotizationNeurotizationTear secretion

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.