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Poster Details

First Author: S.Barros PORTUGAL

Co Author(s):    N. Maques   A. Miranda   J. Cardoso   I. Machado   A. Pereira   N. Campos     

Abstract Details


Corneal alterations potentially leading to ulceration remain a major health concern in ocular surface diseases. A treatment that would improve both quality and speed of healing and control the inflammation would be of great interest. Cacicol® is a new ophthalmologic solution based on ReGeneraTing Agent technology – RGTA. It is a bioengineered analog of extracellular matrix components (heparan sulfates) which promote tissue regeneration. It has been reported as being a potentially useful and noninvasive therapeutic approach in persistent epithelial defects of various etiologies. We aim to present 3 etiologically different cases in which Cacicol® was of major importance.


Ophthalmology Department, Garcia de Orta's Hospital


Case 1: 70 years-old women, previously diagnosed with bullous keratopathy, presented with a neurotrophic ulcer with no improvement despite treatment with topical ofloxacine, preservative free lubricants and occlusion. Therapeutic contact lens was also ineffective with no improvement during 3 months of follow-up. Case 2: 32 years-old women, 9 weeks pregnant, with Graves orbitopathy in the inflammatory phase, presented with extensive keratitis and central ulcer. Management included topical azythromicin, preservative free lubricants hourly and occlusion. No improvement was achieved during 2 months. Case 3: 79 years-old man, with persistent corneal ulcer occupying all graft, 2 weeks after penetrating kerathoplasty.


Case 1: Before attempting more invase techniques, she started treatment with Cacicol® in alternate days with improvement in the ulcer size. Case 2: She started treatment with Cacicol® in alternate days during 2 weeks with reduction of the ulcer size, but keratitis was still evident in the last visit. Case 3: He started treatment with Cacicol® in alternate days, oral doxycycline and occlusion with total improvement.


This work aims to highlight the increasing importance of this new agent in the treatment of difficult cases such as neurotrophic ulcers, as an effective therapeutic agent which prevents or delays more invasive procedures, in particular cases such as ulcers secondary to Graves orbitopathy in which the recommended treatment was not possible or, in less serious situations, such as persistent ulcers after penetrating keratoplasty, in which this can be a quick and effective solution that significantly improves the patient's quality of life.

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