gms | German Medical Science

Purpose: The purpose of the study is to evaluate the effectiveness of new regenerative therapy (ReGeneraTing Agent [RGTA], Cacicol-20) in patients with progressive corneal thinning due to neurotrophic keratopathy.

Methods: Prospective study including 30 patients with neurotrophic keratopathy after HSV infection, facial paralysis and trigeminal neuralgia. For 5 weeks Cacicol-20 eye drops were applied topically once a week in the morning as the first drug. Additionally 0.15 % sodium hialuronate preservative-free lubricating eye drops were used 6 times per day. Evolution before and after the treatment was assessed by the best corrected visual acuity (BCVA) and anterior segment optical coherent tomography CASIA, Tomey. The cornea was divided into 5 zones with first zone in the centre. Before treatment had been performed, the area and the value of the thinnest part of the cornea were determined. Patients were divided into 5 groups based on the minimum value of corneal thickness and its location in certain zone.

Results: 30 eyes of 30 patients underwent topical treatment (18 females and 12 males). Mean age 53.7 (range 21–80 years). The average increase in corneal thickness was 80.45 µm. Between groups the highest increase -83.33 µm was observed in group III, in other groups the increase was: in group I 78.67 µm, group II 76.17 µm, group IV 79.83 µm, group V 70.83 µm, p<0.05. BCVA improvement was noted in 77% cases. No systemic or local side effects of the treatment were reported.

Conclusions: One of the consequences of neurotrophic keratopathy is progressive corneal thinning, which is difficult to treat and may result in corneal perforation. RGTA stopped the progression of corneal thinning and enhanced matrix regeneration. This novel therapy is successful, noninvasive approach in progressive corneal thinning caused by neurotrophic keratopathy.