RGTA seems to be a potentially useful, alternative, noninvasive therapeutic approach in neurotrophic keratopathy management. However, randomized studies are necessary.

Purpose To evaluate the efficacy of a new matrix therapy agent (RGTA, Cacicol®), an analogue of heparan sulphates, for management of severe neurotrophic keratopathy. Methods We carried out a prospective, single‐centre, uncontrolled study of 11 eyes in 11 patients, presenting corneal neurotrophic ulcers, despite use of preservative‐free artificial tears for 15 days. Mean age was 58 years. All patients had corneal anaesthesia. RGTA treatment was instilled in the morning,as the fist eyedrop, on alternate days. Main outcome measures were for each patient healing of the corneal surface and best corrected visual acuity during and after treatment. Results Eight patients displayed complete healing of the ulcer, after a mean period of 8.7 weeks (range; 1 to 22 weeks). Mean ulcer area decreased significantly, from 11.12% to 6.37% (p=0.0479) in the first week, to 1.56% (p=0.0054) at one month. Treatment failure was observed in three cases, requiring amniotic membrane transplantation in two patients and penetrating keratoplasty in one patient. At the end of the study, none of the patients displayed a significant improvement in visual acuity. None of the patients reported pain or discomfort during instillation of RGTA eyedrops. Conclusion This heparin mimetic, which may stimulate extracellular matrix healing, may be a possible, non‐invasive, alternative therapy in severe neurotrophic keratopathy. However, randomized studies are necessary.

Purpose The surgical management of limbal deficiency is difficult, especially when it is bilateral and occupies more than half of the cornea. In these advanced cases, the presence of an associate corneal anesthesia, worsen the prognosis of allo‐limbal transplantation. We aimed to assess the efficacy and tolerance of a new matrix therapy agent (RGTA, Cacicol20), mimicking heparan sulfates, in combination with limbal allograft for the reconstruction of the ocular surface with complete corneal anesthesia. Methods It is a prospective, single‐center study. Six eyes of six patients were included. All were men. The average age was 53 years [range : 35‐87]. Mean follow‐up was 4.8 months [range : 3‐9 months]. Etiologies were corneal burn in three cases, an herpes infection in one case and idiopathic in 2 cases. All patients underwent limbal allograft associated with instillation of eye drops RGTA once every two days in the absence of healing after 7 days postoperatively. A topical steroid is prescribed in all cases. RGTA eye drops were stopped after complete healing. Patients were followed every 7 days until healing. Visual acuity, corneal sensitivity and the surface of the ulcer are evaluated each time using photography. Results Despite the persistence of total corneal anesthesia, the epithelium healed in all cases before 2 months [range 7 days to 2 months}. Two of 6 patients showed significant improvement in their visual acuity. One patient had a corneal abscess regressing under treatment. Conclusion RGTA seems to be a potentially useful, alternative, noninvasive therapeutic in association with limbal allograft in advanced limbal deficiency