Abstract
Purpose :
RGTA / Cacicol® is a recent matrix therapy whose use is now validated for the healing of neurotrophic ulcers refractory to medical conventional treatments. Recent studies have also demonstrated his interest in post crosslinking corneal healing. Our study is the first to evaluate the interest of Cacicol® post Photokeratectomy in order to allow a faster epithelial healing and therefore a less painful symptomatology of patients after this procedure.
Methods :
We conducted a prospective study within the ophthalmology department of Edouard Herriot Hospital (Lyon, FRANCE). Included were patients with refractive photokeratectomy (PKR) or therapeutic refractive photokeratectomy (PTKR). The control group included the left eye of patients with PKR or PTKR. The Cacicol® group included all the right eyes of patients with PKR or PTKR. This group received in addition to the usual post photokeratectomy treatment a drop of Cacicol® which was administered directly after the procedure, then a drop every 48 hours until complete epithelial healing. Patients were seen daily until complete healing of the epithelial ulcer. At each visit were evaluated: the surface of the corneal ulcer by photos analyzed by the ImageJ® software, as well as the painful symptomatology by the visual analogue scale (VAS). Oral analgesics taking were also recorded.
Results :
Between January and November 2018, 30 eyes were included (22 PTKR / 8 PKR): 16 eyes in the Cacicol® arm and 14 in the control group. All the analyzes were done in intention to treat. Faster epithelial healing was noted in the Cacicol® group: on day 2 (D-2) 12 eyes (75%) were healed in the Cacicol® group against 7 eyes (50%) in the control group (p <0.05). All ulcers after photokeratectomy were healed after the 4th day. Similarly, the pain sensation with a lower VAS was noted in the Cacicol® group statistically significantly at D-1 (VAS Cacicol® group: 31.4 against VAS control group: 62.7) and D-2 (VAS Cacicol® group: 12.8 against VAS control group 28.9) postoperatively (p <0.05%). Patients in the Cacicol® group also had less use of analgesics.
Conclusions :
Our study found a faster epithelial healing and a better analgesic control after photokeratectomy in favor of the postoperative use of Cacicol®.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.