Summary
7 · Summary table — evidence & effect
Review — modulators of corneal healing › Summary table
Overview of the 36 agents. Colour pill = simplified scale (Strong · Moderate · Weak · Investigational · Negative).
| Agent | Era | Effect | Oxford | Scale |
|---|---|---|---|---|
| Autologous serum (ASED) | Present | Pro-healing | II–III | Moderate |
| Umbilical cord serum | Present | Pro-healing | II–IV | Moderate |
| PRP / PRGF | Present | Pro-healing | II–IV | Weak–Mod. |
| Cenegermine (Oxervate) | Present | Pro-healing (neurotrophic) | I–II | Strong |
| rhEGF eye drops | Present (Asia) | Pro-healing | II–IV | Weak–Mod. |
| Topical insulin | Present-emerging | Pro-healing | II–IV | Weak–Mod. |
| Thymosin β4 (RGN-259) | Future | Pro-healing (investig.) | II | Investigational |
| KGF (FGF-7) / HGF | Future | Pro-healing (paracrine) | IV–V | Investigational |
| Amniotic membrane / PROKERA | Present | Pro-healing | II–IV | Moderate |
| RGTA (Cacicol withdrawn / Clerapliq vet.) | Human: withdrawn · Vet: present | Pro-healing | III–IV | Weak–Mod. |
| Bandage / scleral contact lenses | Present | Pro-healing (mechanical) | II–IV | Mod.–Strong |
| Sodium hyaluronate | Present | Pro-healing | I–II | Moderate |
| Vitamin A | Present | Pro-healing | I (syst.) / II | Strong (deficiency) |
| Collagen shields | Past | Pro-healing | IV–V | Weak/Investig. |
| N-acetylcysteine | Present | Anti-melt | IV–V | Weak/Investig. |
| Doxycycline (anti-MMP) | Present | Anti-melt | II–IV | Moderate |
| Vitamin C (ascorbate) | Present | Anti-melt | II (exp.) | Mod.–Strong |
| Aprotinin | Past | Anti-melt | IV | Weak/Investig. |
| Tarsorrhaphy / occlusion / botox | Present | Pro-healing (mechanical) | II–IV | Moderate |
| Mitomycin C | Present | Anti-fibrotic (haze) | I–II | Strong |
| Topical losartan | Present-emerging | Anti-fibrotic (haze) | IV | Weak–Mod. |
| Hyperbaric oxygen | Present | Pro-healing (niche) | IV–V | Weak/Investig. |
| BAK (preservative) | Present | Negative (toxic) | I–III | Negative–Strong |
| Topical corticosteroids | Present | Dual / Negative | I–II | Negative (epith.) |
| Topical NSAIDs | Present | Negative | I–III | Negative–Strong |
| Anesthetic abuse | Present | Negative (toxic) | IV | Negative–Strong |
| Aminoglycosides / FQ | Present | Negative (dose) | II/IV | Negative |
| Holoclar (CLET) | Present (EU) | Pro-healing (LSCT) | II | Mod.–Strong |
| CALEC | Future (USA) | Pro-healing (LSCT) | II–III | Investigational |
| Connexin 43 (Nexagon) | Future | Pro-healing | II | Moderate |
| MSC / exosomes | Future | Pro-healing | V | Investigational |
| Gene therapy | Future | Pro-healing / anti-fibrotic | V | Investigational |
| Substance P + IGF-1 | Future | Pro-healing | IV | Weak/Investig. |
| PEDF + DHA | Future | Pro-healing (nerves) | V | Investigational |
| Senolytics | Future | Pro-healing (theoretical) | V | Investigational |
| Platelet lysate (cord blood) | Emerging | Pro-healing | IV | Weak/Investig. |
The 4 major iatrogenic negative modulators: (1) frequent-dose BAK/preservatives;
(2) corticosteroids on a defect or melting cornea (delayed closure, ↓resistance, keratolysis, masking infection);
(3) topical NSAIDs (epithelial delay, sterile melting/perforation — FDA class warning);
(4) topical anaesthetic abuse (non-healing ulcer, perforation). Aminoglycoside toxicity is dose-dependent
(fortified/prolonged regimens).