Healing of resistant corneal neurotrophic ulcers using a matrix regenerating agent.

PURPOSE: To assess the success rate of a matrix regenerating agent (RGTA) in the treatment of chronic corneal ulcers resistant to conventional treatments.

METHODS: Uncontrolled prospective observational study in patients with corneal neurotrophic ulcer (Stage 2 or 3 of the Mackie classification), unresponsive to standard medical or surgical treatments and managed with RGTA as an adjunctive treatment. Corneal ulcers were evaluated using slit-lamp examination and optical coherence tomography after 2 weeks, 1 month, 2 months and 3 months. Success was defined as complete corneal healing.

RESULTS: RGTA was administered to 20 patients (20 eyes) with chronic corneal ulcers of various causes, including keratoplasty (7 eyes, 35.0%), herpetic keratitis (5 eyes, 25.0%) and intracorneal ring (3 eyes, 15.0%). Total corneal healing was observed in 13/20 patients (65.0%) within 1 to 3 months. RGTA was discontinued due to partial healing/ulcer stagnation in 6 patients (30.0%), and aggravation of the ulcer in 1 patient (5.0%). Relapses were reported in 4 patients (20.0%) several months after cessation of RGTA treatment. No adverse reactions were noted.

CONCLUSIONS: In the event of failure of conventional treatments, RGTA may be an alternative medical treatment for patients with chronic corneal ulcers, avoiding the need to resort to surgical treatment.