Zeitschrift für klinische und experimentelle Ophthalmologie
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New Regenerating Agents (RGTA): New Indications in Persistent Corneal Thinning Caused By Fungal Keratitis

Javier Obis, Antonio Mateo, Maria Satue, Antonio Sanchez-Perez, Luis E. Pablo and Miriam Idoipe

Purpose: To assess the effectiveness of new RGTA like Cacicol20 in two cases of persistent corneal ulceration refractory to maximum medical treatment in the context of fungal keratitis.
Methods: Case 1 was a 75-year-old woman with malocclusion after ptosis surgery who presented Candida albicans keratitis (yeast). Case 2 was a contact lens wearer 39-year-old man who presented Fusarium keratitis (filamentous fungus). They both improved with antifungals. However, the corneal thinning caused by the infection persisted despite artificial tears, autologous serum and a bandage contact lense (BCL). OCT showed 226 microns corneal thickness in Case 1 and descemetocele in Case 2. Cacicol 20 one drop every two days for one month was prescribed to both of them at that moment, when the infiltrates still persisted.
Results: After that regimen, Case 1 corneal thickness rose to 391 microns, and Case 2 rose to 224 microns. Complete epithelial healing was achieved in both cases. The infiltrates continued to decrease and they were eventually replaced by sterile leukomas. None of the patients presented new signs of infection afterwards. No precipitates appeared on the BCLs. None of the patients reported any adverse effects.
Conclusion: New RGTA like Cacicol20 could be an effective option for persistent corneal ulceration refractory to maximum conventional medical treatment, which would save surgical procedures. Moreover, they could be prescribed during fungal infection, despite the contraindication in case of active ocular infection that appears in the leaflet of Cacicol20.