This study evaluated the efficacy and safety outcomes of eyes with neurotrophic keratitis (NK) that underwent a course of cenegermin-bkbj (Oxervate) in the presence of a bandage contact lens (BCL).
Investigators conducted a retrospective chart review of 16 patients seen at 2 US eye centers. Assessments included patient demographics, visual acuity, pretreatment and post-treatment slit-lamp examination and corneal sensation, and adverse events. Corneal fluorescein staining was assessed on a scale of 0 to 4, where 0 = no punctate staining and 4 = severe diffuse or coalescent macropunctate staining.
Patients requiring BCL use at the time of cenegermin-bkbj therapy due to recurrent ocular surface decompensation in the setting of NK saw improvements in vision, corneal sensation, size of persistent epithelial defects, and fluorescein staining. Sixty-seven percent of eyes had complete resolution of persistent epithelial defects and improvements in fluorescein staining, while 3% of eyes had improved visual acuity. Corneal sensation was also present in 79% of eyes after treatment. Smaller-diameter BCL use was associated with a higher rate of healed persistent epithelial defects, while larger-diameter BCL use was associated with more quadrants of post-treatment corneal sensation. The most common side effect of cenegermin-bkbj treatment was ocular ache.
The study included only 18 eyes of 16 patients, which is a small cohort. However, NK in general is a rare disease and smaller sample sizes are expected, especially for those patients requiring chronic BCL use. The retrospective nature of the study is also a limitation, and a future prospective study may be warranted.
There is a subset of patients with NK-related persistent epithelial defects who are chronically dependent on BCL use to avoid epithelial breakdown. Treatment with cenegermin-bkbj in the setting of a BCL is considered off label; however, even though this study had a small cohort of patients, results demonstrate that patients who require BCL use during cenegermin-bkbj treatment can successfully have improvements in visual acuity, corneal sensation, epithelial defect size, and fluorescein staining.