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Peer-reviewedCC BYDrugs

Corneal Nerve Injury and Regeneration: Mechanisms, Clinical Consequences, and Emerging Therapeutic Strategies.

  • Athar Shadmani1
  • Anat Galor2,3
  • Houri Esmaeilkhanian4,5
  • Maja Kostic1
5 affiliations
  1. 1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA.
  2. 2Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL, 33136, USA. [email protected].
  3. 3Surgical Services, Miami Veterans Affairs Medical Center, Miami, FL, USA. [email protected].
  4. 4Byers Eye Institute, Stanford School of Medicine, Palo Alto, CA, USA.
  5. 5School of Medicine, Saint Louis University, Saint Louis, MO, USA.
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Abstract

The cornea is among the most densely innervated tissues in the body and depends on intact sensory and autonomic innervation to maintain epithelial integrity, tear film homeostasis, and ocular surface defense. Corneal nerve injury may occur after surgery, infection, inflammation, trauma, or systemic disease and can lead to reduced corneal sensitivity, impaired epithelial healing, dry eye, neuropathic pain, and neurotrophic keratopathy. Effective management requires both treatment of the underlying cause and restoration of a microenvironment permissive for reinnervation. This review examines the mechanisms underlying corneal nerve injury and repair, with emphasis on therapeutic strategies relevant to clinical translation. These include anti-inflammatory and immunomodulatory agents, growth factors and cytokines, blood-derived products, extracellular matrix-based therapies, stem cell- and secretome-based approaches, surgical neurotization, and physical stimulation modalities. We also highlight emerging challenges in the field, including the gap between structural nerve regeneration and functional recovery, limitations in clinical evidence, and barriers to therapeutic accessibility and implementation.

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Cite

BibTeXRIS
BibTeX
@article{shadmani2026corneal,
  title = {{Corneal Nerve Injury and Regeneration: Mechanisms, Clinical Consequences, and Emerging Therapeutic Strategies.}},
  author = {Athar Shadmani and Anat Galor and Houri Esmaeilkhanian and Maja Kostic},
  journal = {Drugs},
  year = {2026},
  month = oct,
  doi = {10.1007/s40265-026-02396-w},
  url = {https://europepmc.org/article/MED/42848137},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Corneal Nerve Injury and Regeneration: Mechanisms, Clinical Consequences, and Emerging Therapeutic Strategies.
AU  - Athar Shadmani
AU  - Anat Galor
AU  - Houri Esmaeilkhanian
AU  - Maja Kostic
PY  - 2026
DA  - 2026/10/08
JO  - Drugs
DO  - 10.1007/s40265-026-02396-w
UR  - https://europepmc.org/article/MED/42848137
AB  - The cornea is among the most densely innervated tissues in the body and depends on intact sensory and autonomic innervation to maintain epithelial integrity, tear film homeostasis, and ocular surface defense. Corneal nerve injury may occur after surgery, infection, inflammation, trauma, or systemic disease and can lead to reduced corneal sensitivity, impaired epithelial healing, dry eye, neuropathic pain, and neurotrophic keratopathy. Effective management requires both treatment of the underlying cause and restoration of a microenvironment permissive for reinnervation. This review examines the mechanisms underlying corneal nerve injury and repair, with emphasis on therapeutic strategies relevant to clinical translation. These include anti-inflammatory and immunomodulatory agents, growth factors and cytokines, blood-derived products, extracellular matrix-based therapies, stem cell- and secretome-based approaches, surgical neurotization, and physical stimulation modalities. We also highlight emerging challenges in the field, including the gap between structural nerve regeneration and functional recovery, limitations in clinical evidence, and barriers to therapeutic accessibility and implementation.
SN  - 0012-6667
SN  - 1179-1950
ER  -