Deric De Wit1,2, Elizabeth SJ Baek3

Purpose: We report a case of a resistant herpetic neurotrophic corneal ulcer successfully treated by combination sequence of matrix regenerating agent (RGTA, Cacicol20^®) followed by amniotic membrane graft.

Methods: We report a case of an 74-year-old female patient, who developed a persistent epithelial ulcer after prolonged hospitalisation for heart failure, with no improvement despite 4 weeks of topical antibiotic and artificial tears. Heparan sulfate mimetic (RGTA, Cacicol20^®) was then used, with a dosage of two eye drops per week for 3 weeks followed by amniotic membrane graft (AMT).

Results: Improvement was observed within 2 weeks of RGTA with complete healing post AMT < total 5 weeks, with no side effects.

Conclusions: The combination of heparin mimetic in conjunction with amniotic membrane transplantation in severe neurotrophic ulcer may have synergistic effect. However, randomized studies are necessary to confirm this encouraging result.