Novel lens capsule transplantation shows promise for neurotrophic keratitis

A recent case highlights the potential of allogeneic anterior lens capsule transplantation (ALCT) in treating neurotrophic epithelial keratitis caused by herpes simplex virus (HSV).

An 81-year-old man with a 3-month history of neurotrophic keratitis in his left eye, following recurrent HSV keratitis over 3 years, showed no improvement despite multiple treatments. His visual acuity was 20/200 in the right eye and no light perception in the left. An examination found an epithelial defect, stromal thinning, and corneal scarring.

To promote healing, an allogeneic anterior lens capsule (ALC) was placed over the defect using fibrin glue, secured with a bandage contact lens. The procedure had no complications. After 2 weeks, the ALC was removed. There was complete epithelial healing, which remained stable 2 months later with reduced corneal scarring.

This case suggests that ALCT may offer a promising new approach for managing neurotrophic keratitis, providing an effective biological dressing to support corneal healing.

Reference
Kymionis GD, Vakalopoulos DG, Chatzea MS, et al. Allogeneic anterior lens capsule transplantation (ALCT) for the management of HSV neurotrophic keratitis. Am J Ophthalmol Case Rep. 2025;38:102292. doi: 10.1016/j.ajoc.2025.102292. PMID: 40104206; PMCID: PMC11919331.