Cacicol® – neurotrophic keratopathy in systematic review

Purpose The objective of this study was to review the cases of neurotrophic keratopathy with use of the new regenerating agent (RGTA) therapy Cacicol®. Methods An analysis was based on documents retrieved from the systematic research on published materials. Bibliometric analysis were performed using own design database. Research has been concentrated on publications, conference abstracts and posters presenting case reports with detailed medical history. Neurotrophic keratopathy patients have been grouped according to diagnosis based on the best assessment of the data presented in the collected materials. In all groups posology, duration of treatment, healing level and tolerance have been assessed by descriptive methods. Results 58 publications have been consecutively retrieved and reviewed from which 37 have been qualified for further review. In this materials 102 patients with 105 eyes have been selected as detailed data of Cacicol® use, performance and tolerance could be identified. The total number of eyes have been divided into 4 groups: postinfectious (n = 33), postoperative (n = 25), neurological (n = 36), chemical burns (n = 11). Analysis revealed that in all groups more than 72% of patients achieved corneal healing/partial healing after average treatment of 4 weeks (from 4 days to 22 weeks). Only 6% of cases did not heal and <2% presented unexpected effect. In the most cases posology covered 1 drop every 2 or 3 days. The recurrence rate of the neurotrophic ulcers after the complete healing was reported up to 20% within 6 months. Conclusions Cacicol® might be considered as an alternative approach in the neurotrophic keratopathy management. However randomised clinical trial in patients in this indication is necessary to confirm the promising effect of Cacicol® in the neurotrophic keratopathy management.