Name

673 - Étude médico-économique comparant un nouvel agent de thérapie matricielle à la greffe de membrane amniotique dans les ulcères épithéliaux persistants après kératite bactérienne traitée antibiotiques topiques fortifiés

To compare the efficacy and cost of a conventional treatment to obtain corneal healing in subjects with persistent epithelial defect after bacterial keratitis (amniotic membrane transplantation) and a new regenerating matrix therapy agent (RGTA).

In 27 patients with a persisting corneal ulcer, 14 patients were treated with RGTA eydrops 3 weeks and 13 patients received amniotic membrane transplantation. The cost of each strategy was evaluated with the hospitalisation cost calculated based on the French national study of public hospital costs and the cost of the subsequent follow-up visits.

Both treatments showed comparable efficacy, with no recurrence in both groups, and 100% of patients treated with RGTA had complete corneal healing at 3 months. The rate of complete corneal healing at 1 month in the amniotic membrane and RGTA groups was not significantly different (80% and 100%, respectively). Visual acuity was significantly (p=0.004) better in the RGTA group (logMAR 1.4 ± 0.5 versus 0.7 ± 0.5), and there was no significant difference concerning the prevalence of side effects. Hospitalization costs were significantly (p=0.0003) lower in RGTA group, with a mean hospitalization costs about 40% lower in this group in comparison to the amniotic membrane transplantation group (3996.8 ± 1192.8 euros versus 6730.0 ± 2027.9 euros). The total 3-month costs were also significantly (p=0.0006) lower in RGTA group (4203.9 ± 1181.6 versus 6810.0 ± 2066.4 euros).

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RGTA eye drops lead to a significant reduction in hospitalization costs and total costs (3 months) by comparison to amniotic membrane transplantation with a similar efficacy.