Stem Cell‐Based Approaches for Neurotrophic Keratopathy: From Ocular Surface to Neuro‐Ophthalmology

Neurotrophic keratopathy is an uncommon, but potentially sight‐threatening, corneal disorder that results from impaired trigeminal sensory innervation. The loss of corneal sensation disrupts epithelial stability, weakens wound healing, and may lead to persistent epithelial defects, stromal ulceration, and, in the most advanced cases, corneal perforation. Although neurotrophic keratopathy has long been managed mainly as an ocular surface disease, it is now better understood as a condition of corneal denervation and failed neuroepithelial homeostasis. In this setting, epithelial breakdown is not simply the consequence of local epithelial dysfunction but reflects the loss of sensory input and trophic support that normally maintain the integrity of the corneal surface. Current therapeutic options, including intensive lubrication, protective surgical procedures, amniotic membrane transplantation, and recombinant human nerve growth factor, can support epithelial healing and stabilize the ocular surface. However, achieving durable recovery of corneal nerve function and long‐term restoration of neuroepithelial integrity remains a major clinical challenge. Against this background, stem cell–based and stem cell–derived approaches have attracted growing interest as potential regenerative strategies for neurotrophic keratopathy and related corneal epithelial disorders.