A retrospective study involving almost 1,000 patients has added to the evidence supporting decellularized basement membrane (DBM) grafts as a potential earlier intervention for neurotrophic keratitis (NK).
Published in Clinical Ophthalmology, the study examined successive applications of Biovance Ocular DBM tissue grafts in patients with chronic subclinical or Mackie Stage 1 NK. The authors – Brandon Ayres, Nicole Fram, Helen Wu, Lisa Feulner, and Neel Desai – evaluated outcomes including corneal epithelial resolution, corneal sensitivity, tear osmolarity, and MMP-9 status.
Among eyes with complete follow-up, corneal epithelial resolution occurred in all cases. Functional corneal sensitivity also improved, with the greatest gains reported in more advanced Brill severity groups: 0.7% of Brill 3 eyes, 31.6% of Brill 4 eyes, and 77.5% of Brill 5 eyes showed improvement.
The study also reported changes in ocular surface biomarkers. Among eyes with abnormal baseline osmolarity, 70–82% normalized following treatment. MMP-9 positivity decreased across all severity groups, with 56–66% of positive eyes converting to negative. Mean DBM use varied by disease severity, with 3.70 grafts used in Brill 3 eyes, 3.08 in Brill 4 eyes, and 4.30 in Brill 5 eyes.
“Neurotrophic keratitis is likely more prevalent than we believe. Should we conduct the appropriate corneal sensitivity testing at patient presentation of symptoms, I believe we will uncover more patients for whom we can intervene sooner, particularly with interventional approaches such as decellularized basement membrane,” said Brandon Ayres. “With corneal epithelial resolution occurring in all eyes with complete follow-up in this study, and seeing functional corneal sensitivity improvement along with high rates of osmolarity normalization and reduction in MMP-9 positivity, I believe Biovance Ocular decellularized basement membrane products can be a first-line approach to NK, so long as corneal sensitivity has been compromised and documented.”
Ayres is due to present related real-world data on the underdiagnosis of NK at the 2026 American Academy of Ophthalmology (AAO) meeting in New Orleans (October 9-12).
