Topical treatment with a new matrix therapy agent (RGTA, CACICOL‐20) improves epithelial wound healing after penetrating keratoplasty

Purpose Complete epithelial wound healing is a milestone in the early post-operative care after penetrating keratoplasty (PKP). It reduces the infectious risk, allows safe instillation of steroids, and conditions discharge from hospitalization. We assessed a new matrix therapy agent, mimicking heparan sulfates, for the management of post PKP epithelial defects Methods Prospective, open-label, uncontrolled, single-centre study on 33 consecutive patients (33 eyes) who benefited from a 8.25 mm PKP for all-comers indications. Patients were treated with RGTA eye drops (THEA): one drop in the operating theater immediately after graft, then on alternate days. Follow-up was performed by slit-lamp examination and photography with fluorescein-dye testing repeated every day at a fixed time. Dye area was measured using the freeware ImageJ. Main outcome: time of corneal surface healing Results All corneas displayed complete healing after a mean 2.7±1.1 days (median 3, range; 1 to 6). Complete wound healing was obtained at D1 for 15%, D2 for 33%, D3 for 88%, D4 for 94%, and D6 for 100%. Area of epithelial defect decreased by a mean 75±22% between D1 and D2 (n=28) corresponding to a wound healing speed of 11.5±6.5 mm2/D. There were no systemic or local side effects. For comparison, in the series of all-comers indications of 1003 PKP without RGTA of Borderie, mean wound healing was 4.6+/-13.2 days (median 2.5, range 1-210). Conclusion RGTA seems a potentially useful, noninvasive therapeutic approach in PKP management. A controlled double blind clinical trial vs placebo will be soon conducted to answer this question conclusively.