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

Abstract

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; P = 0.006) and 8 weeks after treatment initiation (0.9 ± 0.7; P = 0.002) and 1 month (0.6 ± 0.5; P < 0.001) and 6 months after treatment completion (0.8 ± 0.9; P = 0.002) compared to baseline (1.6 ± 0.5). Complete epithelial healing was noted 1 month (42.9%; P = 0.016) and 6 months after treatment completion (38.5%; P = 0.016). Epithelial defect size improved to <5 mm² at all points (P < 0.05) during and after treatment compared to baseline (37.24 mm²). 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.