Current and emerging medical treatment options for corneal persistent epithelial defects

Lixi F. Calabresi V. Giagoni A. Karapinar S. Namazbayeva A. Bergamo Silva F. Coco G. Giannaccare G.
2026 Taylor and Francis Ltd.

Expert Review of Ophthalmology
2026

Introduction: Corneal persistent epithelial defects (PEDs) represent a significant clinical challenge due to their multifactorial etiology and their potential to progress to severe complications. Early recognition and effective medical management of PEDs are essential to prevent worsening up to corneal blindness. Areas covered: A comprehensive search of PubMed, Scopus, Web of Science, and ClinicalTrials.gov was performed, focusing on established treatments as well as novel therapies targeting neurotrophic dysfunction, inflammation, and extracellular-matrix dysregulation. This review synthesizes current and emerging medical therapies for PEDs, emphasizing mechanisms of action and available clinical evidence, finally offering a coherent, evidence-based strategy. Expert opinion: Effective management of PEDs requires a stepwise, mechanism-driven approach that starts with addressing underlying ocular and systemic contributors. While traditional supportive treatments remain foundational, biologically active agents are increasingly crucial for refractory cases. Emerging pathway-specific therapies such as lufepirsen, RGN-259, neurotrophic peptides, growth factors, matrix regenerating peptides, and regenerative secretome-based formulations offer promising targeted strategies, though high-quality evidence remains limited. Future progress will depend on identification of biomarkers guiding therapy selection and robust clinical trials to validate emerging agents and support more personalized treatment algorithms.

autologous serum , corneal healing , dry eye , neurotrophic keratopathy , ocular surface disease , Persistent epithelial defect , platelet-derived products , recombinant human nerve growth factor

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Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
Department of Ophthalmology, St. Johannes Hospital, Dortmund, Germany
Refractive and Laser Surgery Department, Kazakh Eye Research Institute, Almaty, Kazakhstan
Department of Medicine, University Center Padre Albino (UNIFIPA), Sao Paulo, Catanduva, Brazil
Ophthalmology Unit, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy

Eye Clinic
Department of Medical Sciences and Public Health
Department of Ophthalmology
Refractive and Laser Surgery Department
Department of Medicine
Ophthalmology Unit

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Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026