Emily Sarah Charlson, MD, PhD, is a Clinical Instructor of Ophthalmology and the Ophthalmic Plastic & Reconstructive Surgery, Orbital Oncology Fellow with the Byers Eye Institute. She completed her undergraduate degree in Honors Biology at Arizona State University. After discovering genetics research in Arizona, she pursued a combined Medical Scientist Training Program at the University of Pennsylvania with a PhD in Cellular and Molecular Biology. Her thesis centered on the Human Microbiome Project utilizing deep sequencing and bioinformatics to characterize the microbial communities that live on and in the human body in health and disease. After a transitional year internship at Santa Clara Valley Medical Center she completed her Ophthalmology residency with the Gavin Herbert Eye Institute at the University of California, Irvine before coming to Stanford as a Clinical Instructor of Ophthalmology and Oculoplastic and Orbital Oncology Fellow.
Clinical Instructor, Ophthalmology
Corneal Neurotization: A Review of Pathophysiology and Outcomes.
Ophthalmic plastic and reconstructive surgery
The objective of this study is to provide a systematic review of the clinical outcomes of corneal neurotization and present the pathophysiology of corneal wound healing, neurotrophic keratopathy, and corneal neurotization.A literature review of published articles and meeting abstracts between December 2008 and February 2019 in the English language with the terms "corneal neurotization," "corneal neurotisation," "corneal reinnervation," and "neurotrophic keratopathy" was performed. Reported clinical data before and after corneal neurotization, and surgical techniques, were collected and analyzed.A total of 54 eyes that underwent corneal neurotization were identified. Final Logarithm of the Minimum Angle of Resolution (logMAR) best-corrected visual acuity improved to 0.85 (standard deviation [SD] = 0.65) from 1.25 (SD = 0.71) with a mean improvement of 0.41 (SD = 0.55; p < 0.0001). Central corneal sensation measured using Cochet-Bonnet esthesiometer improved from 2.18 mm (SD = 0.4) to 40.10 mm (SD = 18.66) with a mean filament length change of 38.00 mm (SD = 18.95; p < 0.0001). The median time to the reported maximal sensation return was 8 months (interquartile range 6-10). The most common reported limitation to visual recovery was corneal scarring (31.5%). Children (ages 0-17 years) as compared with adults (ages 18-82 years) had significantly greater final central corneal sensation esthesiometry readings, central corneal sensation return, and improvement in the logMAR best-corrected visual acuity (p < 0.011).Neurotrophic keratopathy disturbs the homeostatic balance of trophic factors and trigeminal nerve reflexes needed to support ocular surface health and corneal healing. Corneal neurotization can significantly improve corneal sensation and visual acuity and should be considered for the treatment of refractory neurotrophic keratopathy, especially in pediatric populations.
View details for DOI 10.1097/IOP.0000000000001583
View details for PubMedID 31923091