Topical treatment with a new matrix therapy agent (RGTA) in combination with limbal allograft in ocular surface desease and corneal anesthesia

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Abstract

Purpose

The surgical management of limbal deficiency is difficult, especially when it is bilateral and occupies more than half of the cornea. In these advanced cases, the presence of an associate corneal anesthesia, worsen the prognosis of allo-limbal transplantation. We aimed to assess the efficacy and tolerance of a new matrix therapy agent (RGTA, Cacicol20), mimicking heparan sulfates, in combination with limbal allograft for the reconstruction of the ocular surface with complete corneal anesthesia.

Methods

It is a prospective, single-center study. Six eyes of six patients were included. All were men. The average age was 53 years [range : 35-87]. Mean follow-up was 4.8 months [range : 3-9 months]. Etiologies were corneal burn in three cases, an herpes infection in one case and idiopathic in 2 cases. All patients underwent limbal allograft associated with instillation of eye drops RGTA once every two days in the absence of healing after 7 days postoperatively. A topical steroid is prescribed in all cases. RGTA eye drops were stopped after complete healing. Patients were followed every 7 days until healing. Visual acuity, corneal sensitivity and the surface of the ulcer are evaluated each time using photography.

Results

Despite the persistence of total corneal anesthesia, the epithelium healed in all cases before 2 months [range 7 days to 2 months}. Two of 6 patients showed significant improvement in their visual acuity. One patient had a corneal abscess regressing under treatment.

Conclusion

RGTA seems to be a potentially useful, alternative, noninvasive therapeutic in association with limbal allograft in advanced limbal deficiency

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