|Bandage contact lenses may be used during Oxervate treatment in NK patients to optimize outcomes, study shows. Photo: Paul M. Karpecki, OD. Click image to enlarge.|
Neurotrophic keratitis (NK) is a degenerative disease characterized by altered corneal sensation that may lead to temporary or even permanent visual dysfunction if left untreated. Cenegermin-bkbj 0.002% (Oxervate), a topical form of recombinant human nerve growth factor, offers a new way to promote healing in NK, with clinical trials demonstrating its safety and efficacy. Looking into treatment outcomes with combined Oxervate and bandage contact lens (BCL) use, researchers reported these adjunctive therapies demonstrated improvement in corneal sensation, epithelial defect size and fluorescein staining.
They performed a retrospective chart review of all eyes with a clinical diagnosis of NK treated with Oxervate between 2018 and 2020. Inclusion criteria included Oxervate treatment with a BCL in place. A total of 18 eyes of 16 patients (69% female) with NK treated with Oxervate while having a BCL in place were included for analysis. Demographics, etiology, visual acuity, pretreatment and posttreatment corneal sensation and treatment outcomes were assessed.
After Oxervate treatment, presence of corneal sensation significantly increased from 7% of eyes to 79% of eyes. There was also a significant increase in the number of quadrants with corneal sensation (mean of 0.1 quadrants increased to 1.6 quadrants). Six of 10 eyes (67%) with a persistent epithelial defect experienced complete resolution at the conclusion of treatment, while three additional eyes experienced a decrease in the defect size. Despite all 18 eyes necessitating a chronic BCL before Oxervate treatment, four were able to maintain the epithelium without a BCL after treatment for at least some time.
“In eyes demonstrating previous ocular surface decompensation with discontinuation of a BCL, maintenance of BCL use during treatment with Oxervate may be considered,” the study authors concluded in their paper.
Cheung AY, Shah AP, Pierson KL, et al. Use of cenegermin in the presence of bandage contact lenses. Cornea. 2022;41(1):78-82.