Utility of cenegermin for the management of neurotrophic keratopathy after penetrating keratoplasty.

BACKGROUND

The study aimed to report the outcomes of patients treated with cenegermin 0.002% for neurotrophic keratopathy (NK) following penetrating keratoplasty (PK).

MATERIALS AND METHODS

This retrospective case series included patients evaluated at a tertiary care hospital who completed an 8-week course of cenegermin for NK within 12 months following PK. The primary outcome measure was NK stage, while secondary outcomes included complete epithelial healing, epithelial defect size, and best-corrected visual acuity (BCVA) at baseline and four time points during and following treatment. We also evaluated disease progression.

RESULTS

Fourteen eyes of 14 patients were included and demonstrated significant improvement in NK stage at 4 weeks (1.1 ± 0.7; = 0.006) and 8 weeks after treatment initiation (0.9 ± 0.7; = 0.002) and 1 month (0.6 ± 0.5; < 0.001) and 6 months after treatment completion (0.8 ± 0.9; = 0.002) compared to baseline (1.6 ± 0.5). Complete epithelial healing was noted 1 month (42.9%; = 0.016) and 6 months after treatment completion (38.5%; = 0.016). Epithelial defect size improved to <5 mm at all points ( < 0.05) during and after treatment compared to baseline (37.24 mm). Improvement in BCVA was not significant at any time point. Two (14.3%) patients experienced disease progression up to 6 months of follow-up.

CONCLUSIONS

Following an 8-week course of cenegermin, patients with a history of PK demonstrated improvement in NK stage, epithelial healing, and reduced epithelial defect size lasting 6 months after treatment completion. Patients with prior PK and NK may be considered candidates for cenegermin treatment.