Corneal nerve regeneration and ocular surface restoration following treatment with autologous serum eye drops in patients with paralytic lagophthalmos and neurotrophic keratitis
- 1Department of Sense Organs, Sapienza – University of Rome, Viale del Policlinico 155, Rome, 00161 Italy
Abstract
Purpose: To investigate the effect of 20% autologous serum eye drops (ASED) in improving ocular surface condition and promoting corneal nerve regeneration in patients with Paralytic Lagophthalmos (PL) and Neurotrophic Keratitis (NK).
Methods: This prospective study included 11 patients with unilateral NK and PL treated with 20% ASED for 2 months. Ocular surface assessment included Schirmer I test, non-invasive tear film break-up time (NIBUT), Oxford staining score, Ocular Surface Disease Index (OSDI) and corneal esthesiometry. In vivo confocal microscopy (IVCM) was used to quantify changes in corneal subbasal nerve plexus, evaluating corneal nerve fiber length (CNFL), nerve fiber density (CNFD), and nerve branch density (CNBD). Pre- and post-treatment values were compared.
Results: Ten patients completed the study. ASED treatment significantly improved Schirmer I values (mean: 10.3 ± 4.7 mm to 19.7 ± 12.1 mm; p = 0.041), OSDI scores (21.1 ± 12.9 to 17.0 ± 10.0; p = 0.009), and corneal sensitivity readings (central esthesiometry: 3.4 ± 1.9 mm to 5.0 ± 1.2 mm; p = 0.005). IVCM revealed significant increases in CNFL (11.1 ± 6.4 to 14.7 ± 7.3 mm/mm²; p = 0.006) and CNFD (23.1 ± 13.2 to 33.8 ± 11.9 fibers/mm²; p = 0.012). One patient discontinued treatment due to ocular discomfort.
Conclusion: Topical 20% ASED improved both functional and structural parameters in patients with PL and NK, suggesting neuroregenerative potential. These findings support the use of ASED as a therapeutic option in complex ocular surface disease, with IVCM as a valuable tool for monitoring nerve recovery.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00417-026-07388-w.
Related
- Metabolic, Endocrine, and Neurotrophic Responses to a 4v4 Small-Sided Game Following Brief Music or Mindfulness After a Mental-Fatigue Exposure: A Randomized Crossover Trial
- Development of mechanically optimized biomimetic hybrid scaffold–stem cell constructs for functional tendon regeneration and restoration of mechanical integrity
- Bacteroides fragilis Abscess Associated With Fat Necrosis Following Breast Augmentation With Autologous Fat Grafting: A Case Report With Review of the Literature.
- Leucocytes, cytokines and satellite cells: what role do they play in muscle damage and regeneration following eccentric exercise?
- Spatially heterogeneous restoration of spermatogenesis in the mouse testis following experimental cryptorchidism and orchidopexy
BibTeX
@article{lucchino2026corneal,
title = {{Corneal nerve regeneration and ocular surface restoration following treatment with autologous serum eye drops in patients with paralytic lagophthalmos and neurotrophic keratitis}},
author = {Luca Lucchino and Elvia Mastrogiuseppe and Francesca Giovannetti and Mattia D’Andrea and Giulia Mecarelli and Alice Bruscolini and Alessandro Lambiase and Marco Marenco},
journal = {Graefe's Archive for Clinical and Experimental Ophthalmology},
year = {2026},
month = jul,
doi = {10.1007/s00417-026-07388-w},
url = {https://doi.org/10.1007/s00417-026-07388-w},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Corneal nerve regeneration and ocular surface restoration following treatment with autologous serum eye drops in patients with paralytic lagophthalmos and neurotrophic keratitis
AU - Luca Lucchino
AU - Elvia Mastrogiuseppe
AU - Francesca Giovannetti
AU - Mattia D’Andrea
AU - Giulia Mecarelli
AU - Alice Bruscolini
AU - Alessandro Lambiase
AU - Marco Marenco
PY - 2026
DA - 2026/07/17
JO - Graefe's Archive for Clinical and Experimental Ophthalmology
DO - 10.1007/s00417-026-07388-w
UR - https://doi.org/10.1007/s00417-026-07388-w
AB - Purpose: To investigate the effect of 20% autologous serum eye drops (ASED) in improving ocular surface condition and promoting corneal nerve regeneration in patients with Paralytic Lagophthalmos (PL) and Neurotrophic Keratitis (NK). Methods: This prospective study included 11 patients with unilateral NK and PL treated with 20% ASED for 2 months. Ocular surface assessment included Schirmer I test, non-invasive tear film break-up time (NIBUT), Oxford staining score, Ocular Surface Disease Index (OSDI) and corneal esthesiometry. In vivo confocal microscopy (IVCM) was used to quantify changes in corneal subbasal nerve plexus, evaluating corneal nerve fiber length (CNFL), nerve fiber density (CNFD), and nerve branch density (CNBD). Pre- and post-treatment values were compared. Results: Ten patients completed the study. ASED treatment significantly improved Schirmer I values (mean: 10.3 ± 4.7 mm to 19.7 ± 12.1 mm; p = 0.041), OSDI scores (21.1 ± 12.9 to 17.0 ± 10.0; p = 0.009), and corneal sensitivity readings (central esthesiometry: 3.4 ± 1.9 mm to 5.0 ± 1.2 mm; p = 0.005). IVCM revealed significant increases in CNFL (11.1 ± 6.4 to 14.7 ± 7.3 mm/mm²; p = 0.006) and CNFD (23.1 ± 13.2 to 33.8 ± 11.9 fibers/mm²; p = 0.012). One patient discontinued treatment due to ocular discomfort. Conclusion: Topical 20% ASED improved both functional and structural parameters in patients with PL and NK, suggesting neuroregenerative potential. These findings support the use of ASED as a therapeutic option in complex ocular surface disease, with IVCM as a valuable tool for monitoring nerve recovery. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00417-026-07388-w.
SN - 0721-832X
SN - 1435-702X
ER -