Official ESCRS | European Society of Cataract & Refractive Surgeons


New extracellular matrix regenerative agent (RGTA-Cacicol®) in the medical management of persistent corneal epithelial defects

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Session Details

Session Title: Cornea: Medical

Session Date/Time: Monday 16/09/2019 | 08:30-10:30

Paper Time: 09:30

Venue: Free Paper Forum: Podium 2

First Author: : M.Molero Senosiain SPAIN

Co Author(s): :    L. Salazar Quiñones   S. Aguilar Munoa   J. Gegundez Fernandez   A. Muñoz Hernandez   D. Diaz Valle                 

Abstract Details


Corneal epithelial defects and ulcers are sometimes difficult to manage with conventional therapies and often require surgical treatment. RGTA-Cacicol®, a new regenerative matrix agent, has been studied in animal models and showed efficacy as topical therapy in corneal ulcers as well as a potential neuroregenerative effect. As few studies have been conducted in humans, we present this case series of corneal lesions treated with RGTA-Cacicol®.


Cacicol® (a linear polymer of carboxymethyl cellulose) belongs to the regenerating agents therapeutic class (or RGTA) and is specifically intended for corneal matrix repair. It triggers regeneration of damaged tissues for enhanced healing and therefore may delay or prevent invasive surgical procedures.


A retrospective study was carried out in 8 patients over 18 years old with a diagnosis of corneal epithelial defect or neurotrophic ulcer who showed no improvement under maximal medical therapy. At that moment, treatment with RGTA (Cacicol20, OTR3, Paris, France) was started in Hospital Clinico San Carlos (Madrid, Spain) between 2014 and 2018. The following information was collected: demographic data, slit lamp examination (photographs included), medical treatment and duration, RGTA onset, number of treatment courses, interval between courses, patient evolution and final outcome (success versus failure), as well as surgical interventions in case of failure.


A total of 11 eyes were included: lesions were found in patients with previous infectious keratitis (2), herpetic neurotrophic keratitis (3), cicatricial pemphigoid (1), facial palsy (2), immunosuppression (1) and diabetes (2). All patients received maximal medical treatment between 12 and 67 days before starting RGTA. Of them, 72.7% (8/11) showed complete healing, 3 required amniotic membrane transplantation and 1 underwent penetrating keratoplasty. Number of RGTA courses needed were 1 in 4 patients, 2 in 4 patients, 3 in 1 patient and 4 in 2 patients. The interval between RGTA courses ranged from 0 to 42 days.


The new therapy with matrix regenerator agent RGTA-Cacicol is a useful alternative for complicated ulcers or corneal defects unresponsive to conventional treatment. More than one RGTA course can be used when needed with positive results. Long intervals between courses may decrease effectiveness of treatment. New prospective studies should be carried out in which other variables such as lesion size and visual acuity are recorded before, during and after treatment. Authors do not have any financial, economical or industrial interest in the product. Authors did not have receive any remuneration from the mentioned company.

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