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Recombinant human nerve growth factor as adjunctive perioperative therapy in eyes with neurotrophic keratitis undergoing corneal surgery
Presenter:
Blaze Ann Carbonell
Authors:
Blaze Ann Carbonell, BSc (1); Wendy Huang, MD (2); Olivia L. Lee, MD (1)
1. University of California Irvine, School of Medicine
2. Retina Macula Institute of Arizona
Affiliation:
Purpose:
The aim of our retrospective case series is to report the clinical impact of recombinant human nerve growth factor (Cenegermin 0.02%) on surgical outcomes in eyes with neurotrophic keratopathy (NK) that were undergoing corneal surgery. Our findings provide novel real-world data on a population that was previously excluded from clinical trials.
Methods:
All patients were treated at our clinic between April 2021 through February 2025. Topical cenergermin was administered per manufacturer’s instructions in the affected eye; the 8 week course was initiated before or after corneal surgery. Patients lost to follow-up during the treatment period were excluded. Data collected included demographics, NK stage, duration of epithelial defect prior to and after treatment, and timing of Cenergermin initiation relative to surgery. Diagnoses and causes of NK were determined based on patient history and clinical course. Procedures were performed by a single surgeon.
Results:
This study included 21 eyes of 21 patients who underwent either penetrating keratoplasty (n=13), endothelial keratoplasty (n=3), superficial keratectomy (n=2), deep anterior lamellar keratoplasty (n=1), or simple limbal epithelial transplantation (n=1). 42.9% of eyes received pre-operative cenegermin due to a known history of NK prior to planned surgical intervention. 42.9% of eyes received post-operative cenegermin for persistent epithelial defect following routine corneal surgery deemed to be secondary to NK. 14.3% of eyes received cenegermin in combination with emergency tectonic keratoplasty in the setting of severe NK stage 3. All eyes in this series achieved epithelialization after corneal surgery with use of adjuvant cenegermin.
Conclusion:
Patients with severe neurotrophic keratitis undergoing corneal surgery are at increased risk for complications such as delayed epithelialization, corneal melt, secondary infectious keratitis, and corneal perforation. Our series demonstrates that Cenegermin serves as an effective adjuvant therapy to support epithelial healing and improve surgical outcomes for these high risk eyes.