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Table 3 Potential treatments by neurotrophic keratopathy stage (rated as optimal in at least one stage)

From: Expert consensus on the identification, diagnosis, and treatment of neurotrophic keratopathy

 

Early/less severe (e.g., Stage 1)

Moderate (e.g., Stage 2)

Later/more severe (e.g., Stage 3)

Discontinue all preservative-containing topical medications

a

a

a

Medical management

 Topical preservative-free drops

a

a

a

 Topical preservative-free gel drops or ointments

a

a

a

 Autologous serum drops, human umbilical cord serum, platelet rich plasma

a

a

a

 Recombinant human nerve growth factor (cenegermin)

b

a

a

 Prophylactic topical preservative-free antibiotics (excluding aminoglycosides)

 

a

a

 Matrix metalloproteinases inhibitors

b

a

a

Non-surgical intervention (i.e., office procedures)

 Corneal therapeutic contact lenses

b

a

b

 Fresh-frozen self-retained amniotic membrane

 

a

a

 Punctal occlusion

a

a

a

 Synthetic (cyanoacrylate) tissue adhesive

  

a

Surgical intervention (i.e., operating room procedures)

 Tarsorrhaphy

 

b

a

 Amniotic membrane transplant

 

b

a

 Corneal neurotization

 

b

a

  1. aTreatments rated as potentially optimal, depending on the patient’s individual circumstances
  2. bTreatments rated as potentially appropriate, depending on the patient’s individual circumstances (not noted in the manuscript)