gms | German Medical Science

Introduction: The treatment based on autologous PRF (platelets rich fibrin) and activated autologous PRP(platelets rich plasma) shows very promising results in inflammation, corneal regeneration and the healing process of the ocular surface, under optimal conditions of preparation and rationalization of the cell fractions obtained, using determined settings.

Patients and methods: The technique using a graft of an autologous PRF-membrane, freshly prepared, on the cornea of herpetic cause after corneal debridement, seeded with autologous limbal epithelial cells harvested from the healthy eye (Case 1). The second case (Case 2) we treated a corneal degeneration with bilateral keratitis in a 14-year-old girl treated with conventional treatment without success, corneal opacities, and limbal stem cells deficiency (LSCD), of 360 degrees with corneal neovascularization, were treated by 10/0 spatulated needle punctures cauterization and grafting of a fresh prepared PRF-Membrane in sterile operating condition, than injection of activated PRP (0.3 ml) in the subconjunctival space after preparation. Case 3: We treated neurotrophic corneal ulcer following an endocyclophotocoagulation for glaucoma, which was complicated by hypotonia (IOP=6 mmHg) without improvement under conventional treatment, we used a PRF membrane graft, freshly prepared, from the patient’s autologous blood, reinforced with of (0.3 ml) A-PRP in the sub conjunctival space. Case 4: A case of corneal edema after an IOL exchange in a patient previously operated for cataract and whose implant became opacified, treated with conventional treatment for 2 months without success, which we treated by a subconjunctival Injection of activated A-PRP 0.4 ml.

Results: Case 1: A clearing of the cornea of 70% was observed after 10 days in post-treatment, with an improvement in visual acuity of 0.1 to 0.7 on the Snellen chart. 2: Treated with (PRF membrane) MB-PRF and 0.3 ml A-PRP activated after cauterization of the new vessels in his right eye, we observed corneal clearing and disappearance of the new vessels an improvement in acuity of 3 lines. Case 3: Improvement started after 8 days with disappearance of the ulcer and increase in IOP to 13 mmHg, and subjective improvement in visual acuity. Case 4: Showed a clearing of the cornea after 8 days and we were able to highlight a haptic piece of an IOL accidentally hooked at the level of the irido-corneal angle, at the origin of the refractory corneal edema.

Discussion: The injection of activated A-PRP and the PRF membrane graft are very effective in the management of corneal regeneration thanks to the bioactive substances produced by thrombocytes. However larges sized studies are needed, to establish the efficacy.