Topical treatment with a new matrix therapy agent (RGTA, CACICOL) improves epithelial wound healing after penetrating keratoplasty in a rabbit model

Purpose Epithelial wound healing is a milestone in the early post‐operative care after penetrating keratoplasty (PKP). It reduces the infectious risk, allows safe instillation of steroids, and conditions discharge from hospitalization. The present study assessed a new matrix therapy agent, for the management of post PKP epithelial defects in a preclinical rabbit model of PKP. Methods New Zealand white rabbits received a 7.1/7 mm PKP with a desepithelialized rabbit cornea from the same sibling. Immunosuppression was obtained thanks to subconjonctival corticosteroid. Rabbits were randomized to receive either CACICOL (n = 3) or a placebo (n = 3). Investigators were masked. Eyedrops were instilled immediately after graft and repeated on alternate day until complete reepithelilalization. The epithelial wound healing was monitored fluorescein staining. Corneal thickness was monitored using AS‐OCT. Rabbits were euthanatized and corneas were analyzed using histological cross sections, confocal microscopy, scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Results Corneas receiving CACICOL healed in 6, 6 and 8 days versus 8, 8 and 10 days with the placebo (P = 0.099). Epithelial thicknesses were 45, 32 et 23 μm with CACICOL and 25, 29 et 19 μm with the placebo. In SEM superficial cells of the CACICOL group were similar to normal corneas and had more numerous microvilli with the placebo. MET showed normal epithelial ultrastructure in the CACICOL group with more hemidesmosomes than with the placebo. Conclusions RGTA seems a potentially useful, noninvasive therapeutic approach in PKP management.