Effect of a New Matrix Therapy Agent in Persistent Epithelial Defects After Bacterial Keratitis Treated With Topical Fortified Antibiotics

PURPOSE:To evaluate the effect of topical application of a matrix regenerating agent (RGTA) in subjects with a persistent epithelial defect after bacterial keratitis treated with topical fortified antibiotics. METHODS:In this prospective case series of 14 subjects (14 eyes) with a persisting corneal ulcer after the cessation of fortified antibiotics, subjects were treated with an RGTA at a dose of 1 drop every other day. The main outcome measure was the proportion of subjects with complete corneal healing 1 month after initiation of treatment. The secondary outcome measures were the size and depth of corneal ulceration at 1 month, the duration from treatment initiation to complete healing, pain, and tolerability. The ulceration depth was measured with anterior segment optical coherence tomography. RESULTS:Complete corneal healing was observed in 11 (78.6%) of the 14 patients after 1 month and in 14 of the 14 (100%) patients after 3 months. Mean logarithm of the minimum angle of resolution visual acuity improved from 1.22 ± 0.59 at inclusion to 0.57 ± 0.68 at 1 month and to 0.55 ± 0.68 at 3 months (P < 0.01). Pain according to a visual analog scale decreased from 0.34 ± 0.25 to 0.05 ± 0.09 at 1 month and to 0 at 3 months (P < 0.001). Amniotic membrane transplantation was not required for any patients. There were no RGTA-related side effects, and none of the patients reported pain or discomfort during instillation of the drops. CONCLUSIONS:The RGTA seems to be efficient for the treatment of a persistent epithelial defect after bacterial keratitis treated with topical fortified antibiotics.