Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus

Kymionis, George D.; Liakopoulos, Dimitris; Grentzelos, Michael A.; Tsoulnaras, Konstantinos I.; Detorakis, Εfstathios T.; Cochener, Béatrice; Tsilimbaris, Miltiadis K.

doi:10.1097/ico.0000000000000484

Cited by 26 publications

(20 citation statements)

References 12 publications

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“…In Kymionis et al's study, RGTA was administered on the surface of the contact lens once every day, which was slightly overdosed in comparison with the recommended dose (one drop every day). 27 A brief explanation of extracellular matrix remodeling may help us to understand the possible ad- RGTA After Epi-off CXL for Keratoconus/Gumus et al verse effect of overuse on wound healing. In a damaged inflamed tissue, extracellular matrix components are actively destroyed, endocytosed, and degraded in the lysosomes of the cell, and newly synthetized matrix elements are secreted outside the cell to form a new extracellular matrix.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, there is only one published study about this indication. 27 Kymionis et al evaluated the effect of an RGTA (Cacicol-poly-carboxymethyl glucose sulfate) eye drop on corneal healing and ocular pain in 18 patients after CXL. 27 In their study, one eye of each patient randomly received Cacicol once a day and the fellow eye received artificial tears.…”

Section: Discussionmentioning

confidence: 99%

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A New Matrix Therapy Agent for Faster Corneal Healing and Less Ocular Discomfort Following Epi-off Accelerated Corneal Cross-linking in Progressive Keratoconus

Gümüş¹,

Guerra²,

Marques³

et al. 2017

J Refract Surg

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PURPOSE: To investigate the hypothesis that a new matrix therapy agent (ReGeneraTing Agent, [RGTA]) would speed up the corneal reepithelialization, improve stromal healing, and reduce ocular symptoms after epi-off corneal cross-linking (CXL). METHODS: Sixty eyes of 60 patients with progressive keratoconus were enrolled in the study. Epi-off accelerated CXL was performed in all patients. Sixty eyes were randomized into two groups according to use of RGTA eye drops prior to contact lens fitting at the end. Identical medical agents were started postoperatively for the two groups. All participants were monitored on 3 consecutive days after the CXL. Ocular pain, burning, stinging, tearing, photophobia, conjunctival hyperemia, and corneal healing status were evaluated. RESULTS: By day 2, 25 eyes (83.3%) with RGTA revealed complete healing compared to 4 eyes (13.3%) that revealed complete healing in the control group ( P < .001). All eyes had complete corneal epithelial defect closure by day 3 in both groups. Ocular pain scores were lower in the RGTA group on days 0, 1, and 2 (all P < .05). Burning scores were lower on days 1 and 2; stinging scores on days 2 and 3; tearing scores on days 2 and 3; and photophobia on days 1 and 2 ( P < .05) in the RGTA group compared to the control group. CONCLUSIONS: RGTA ophthalmic solution facilitates corneal healing by reconstructing the extracellular matrix in the wound area, leading to an earlier relief of symptoms for patients. [ J Refract Surg. 2017;33(3):163–170.]

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A New Matrix Therapy Agent for Faster Corneal Healing and Less Ocular Discomfort Following Epi-off Accelerated Corneal Cross-linking in Progressive Keratoconus

Gümüş¹,

Guerra²,

Marques³

et al. 2017

J Refract Surg

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“…[66] Corneal healing post corneal collagen crosslinking-Enhanced re-epithelialization compared to control treated eyes.Kymionis et al . [67] Herpes zoster corneal neurotrophic ulcer-Case report: complete corneal healing after 2 weeks.De Monchy et al . [68] Persistant epithelial ulcers−11 eyes treated, pain relief and improvement in 9 cases.Chebbi et al .…”

Section: Rgta® In the Clinicmentioning

confidence: 99%

“…In patients with keratoconus, whereby the corneal epithelium was removed using transepithelial phototherapeutic keratectomy, treatment with RGTA ® led to complete reepithelialization in 61.1 % of eyes after 3 days, compared to 11.1 % of control eyes [67]. …”

Section: Rgta® In the Clinicmentioning

confidence: 99%

RGTA® or ReGeneraTing Agents mimic heparan sulfate in regenerative medicine: from concept to curing patients

et al. 2016

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The importance of extracellular matrix (ECM) integrity in maintaining normal tissue function is highlighted by numerous pathologies and situations of acute and chronic injury associated with dysregulation or destruction of ECM components. Heparan sulfate (HS) is a key component of the ECM, where it fulfils important functions associated with tissue homeostasis. Its degradation following tissue injury disrupts this delicate equilibrium and may impair the wound healing process. ReGeneraTing Agents (RGTA®s) are polysaccharides specifically designed to replace degraded HS in injured tissues. The unique properties of RGTA® (resistance to degradation, binding and protection of ECM structural and signaling proteins, like HS) permit the reconstruction of the ECM, restoring both structural and biochemical functions to this essential substrate, and facilitating the processes of tissue repair and regeneration. Here, we review 25 years of research surrounding this HS mimic, supporting the mode of action, pre-clinical studies and therapeutic efficacy of RGTA® in the clinic, and discuss the potential of RGTA® in new branches of regenerative medicine.

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“…All dogs underwent complete examination of both eyes; among the 11 dogs enrolled, 5 underwent a diamond burr debridement at the clinic, and then all dogs received the matrix therapy agent Clerapliq ® eye drop every 3 days (1 drop, q3d) until ulcer healing (usually between 1-3 months). The structure, synthesis pathway, and potential applications of the active substance OTR4120 (CAS RN: 227322-59-0) are presented elsewhere [28], and it belongs to ReGeneraTing Agents (RGTA ® ) family. OTR4120 is already used in two commercially available products for the treatment of corneal lesions and chronic ulcers for humans and pets (Cacicol20 ® and Clerapliq ® , respectively) in Europe, with more than 50,000 patients and pets treated in the last 5 years [28].…”

Section: New Regenerative Matrix Treatmentmentioning

confidence: 99%

Case Reports for Topical Treatment of Corneal Ulcers with a New Matrix Therapy Agent or RGTA® in Dogs

Martinez¹,

Chiappini²,

Barritault

2019

Veterinary Sciences

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Superficial corneal ulcers that fail to heal within a normal time period and are refractory to conventional therapy in dogs are common in veterinary practice. Different etiologies can lead to this result, including spontaneous chronic corneal epithelial defects (SCCEDs) and ulcerative keratitis associated with bullous keratopathy. Thus, there is an urgent need to find new therapeutic approaches such as matrix therapy replacement. To determine the efficacy of a new ophthalmic treatment (Clerapliq ® ) for SCCEDs and ulcerative keratitis associated with bullous keratopathy, a total of 11 dogs referred to the clinic because of nonhealing erosive ulcers after a classic primary treatment were enrolled to get this new treatment. Dogs underwent ophthalmic exams and 7 dogs (10 eyes) were diagnosed with superficial ulceration and 4 dogs (5 eyes) with bullous keratopathy due to endothelial dystrophy/degeneration. They received eye drops of Clerapliq ® every 3 days until recovery. The results showed that the corneas with recurrences of the ulcers were resolved predominantly by using Clerapliq ® every 3 days in 83.3% of the cases during a period of treatment ranging between 6 to 35 days. Therefore, this new approach using matrix therapy regenerating technology in treating superficial ulcers and bullous keratopathy in dogs can be successfully considered as an adjunctive therapy.

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Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus

Abstract: RGTA (Cacicol20) instillation seems to result in faster corneal reepithelialization after CXL in this study. However, there was no significant effect in subjective pain/discomfort.

Cited by 26 publications

References 12 publications

A New Matrix Therapy Agent for Faster Corneal Healing and Less Ocular Discomfort Following Epi-off Accelerated Corneal Cross-linking in Progressive Keratoconus

A New Matrix Therapy Agent for Faster Corneal Healing and Less Ocular Discomfort Following Epi-off Accelerated Corneal Cross-linking in Progressive Keratoconus

RGTA® or ReGeneraTing Agents mimic heparan sulfate in regenerative medicine: from concept to curing patients

Case Reports for Topical Treatment of Corneal Ulcers with a New Matrix Therapy Agent or RGTA® in Dogs

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