title: Effect of the Regenerative Agent Poly(Carboxymethylglucose Sulfate) on Corneal Wound Healing After Corneal Cross-Linking for Keratoconus.
abstract: OBJECTIVE
  To evaluate the effect of a regenerative agent (RGTA) [Cacicol20-poly(carboxymethyl glucose sulfate); OTR3, Paris, France] on corneal reepithelialization and pain after corneal cross-linking (CXL) for keratoconus.
  
  
  METHODS
  In this prospective comparative (contralateral) clinical study, patients with bilateral progressive keratoconus underwent CXL treatment. The corneal epithelium during CXL was removed using transepithelial phototherapeutic keratectomy (Cretan protocol). One eye of each patient was randomly instilled with an RGTA (Cacicol20) once a day (study group), whereas the fellow eye was instilled with artificial tears (control group). Patients were examined daily until complete reepithelialization. Postoperative examinations included slit-lamp biomicroscopy to assess the epithelial defect size and subjective evaluation of pain.
  
  
  RESULTS
  The study enrolled 18 patients (36 eyes). The mean epithelial defect size for study and control groups was 19.6 ± 4.2 mm versus 21.5 ± 2.8 mm, respectively, at day 1 (P = 0.019) and 6.4 ± 3.4 mm versus 7.9 ± 4.3 mm, respectively, at day 2 (P = 0.014). At day 3 postoperatively, 61.1% of study eyes were fully reepithelialized, compared with 11.1% of control eyes (P = 0.002).
  
  
  CONCLUSIONS
  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.
authors.affiliation: *Faculty of Medicine, Department of Ophthalmology, Vardinoyiannion Eye Institute of Crete (VEIC), University of Crete, Heraklion, Greece; †Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL; and ‡Bâtiment 4 bis, Department of Ophthalmology, University Hospital, Brest, France.
authors.forename: George D
authors.initials: GD
authors.lastname: Kymionis
authors.forename: Dimitrios A
authors.initials: DA
authors.lastname: Liakopoulos
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grentzelos
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Tsoulnaras
authors.forename: Efstathios T
authors.initials: ET
authors.lastname: Detorakis
authors.forename: Béatrice
authors.initials: B
authors.lastname: Cochener
authors.forename: Miltiadis K
authors.initials: MK
authors.lastname: Tsilimbaris
mesh_terms: D000293:Adolescent; D000328:Adult; D003094:Collagen / Q000378:metabolism; D003319:Corneal Stroma / Q000378:metabolism*; D003432:Cross-Linking Reagents; D019573:Epithelium, Corneal / Q000502:physiology*; D058447:Eye Pain / Q000188:drug therapy; D005260:Female; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012038:Regeneration; D012256:Riboflavin / Q000627:therapeutic use; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
chemical_list: D003432:Cross-Linking Reagents; D006025:Glycosaminoglycans; C533322:OTR4120; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin