Conjunctival Neuroma After Corneal Neurotization in a Patient With Neurotrophic Keratopathy
Bibliographic record
Abstract
PURPOSE: To report a rare case of conjunctival neuroma after a successful corneal neurotization surgery. METHODS: The clinical file and histopathology slides of this patient who underwent surgical corneal neurotization for a neurotrophic keratopathy in the right eye were reviewed. RESULTS: A 70-year-old man with a history of severe herpetic (varicella zoster) neurotrophic keratopathy and keratouveitis in the right eye developed a corneal perforation, which required tectonic keratoplasty (May 2020). Corneal neurotization was performed 1 year later without complication, using the ipsilateral supraorbital and supratrochlear nerves to reinnervate the right cornea (April 2021), followed by repeat penetrating keratoplasty (September 2021). Three months later, a superonasal conjunctival mass was observed with a contiguous corneal delle and melt at the corneal-host junction. In vivo confocal microscopy showed numerous nerve fibers within the conjunctival mass, suggesting a diagnosis of conjunctival neuroma. The mass was surgically debulked, and the diagnosis was confirmed by histopathology and immunohistochemistry. The delle and corneal melt were successfully treated with an amniotic membrane. CONCLUSIONS: To the best of our knowledge, this is the first case of confirmed conjunctival neuroma reported after corneal neurotization. Confocal microscopy, histopathology, and immunohistochemistry have proven to be highly useful tools for the prompt recognition and accurate diagnosis necessary for the proper management of this rare complication.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".