New regenerating agent may facilitate post-CXL corneal healing

This prospective, randomized, single-masked study assessed the ability of a new matrix therapy regenerating agent (RGTA) to speed corneal healing following epithelial-off corneal crosslinking (CXL).

Cacicol (Laboratoires Théa) is a new type of RGTA that functions as a scaffold for corneal healing by reconstructing the extracellular matrix in the wound area, leading to earlier relief of symptoms for patients.

RGTAs have been used in other applications to improve the quality and speed of wound recovery, but ocular applications remain limited. Early studies investigating RGTAs for corneal ulcers and dystrophies of various etiologies have been encouraging.  

Study design

Sixty eyes of 60 patients with progressive keratoconus were randomized to receive RGTA combined with standard treatment or standard treatment alone. All eyes underwent accelerated epithelial-off CXL, after which half of the cohort received 1 drop of RGTA prior to contact lens fitting. Both groups were started on identical postoperative medications and were monitored for 3 consecutive days.

Outcomes

At 2 days postop, 25 of 30 eyes (83%) that received RGTA had healed completely, compared with just 4 of 30 eyes (13%) in the control group (P<0.001).

RGTA-treated eyes also had significantly better scores for ocular pain (days 0, 1 and 2), for burning and photophobia (days 1 and 2) and for tearing and stinging (days 2 and 3; all P<0.05).

Clinical significance

One the of the more common complications of epithelial-off CXL is delayed epithelialization. Aside from slower visual recovery, delayed healing results in an increased risk of infection and corneal haze. A single drop of RGTA has the potential to decrease this risk, and does not pose a burden on the patient.