Contribution Of Autologous Platelet Gel For The Treatment Of Severe Corneal Ulcers: First 10 Case Reports

Severe corneal ulcers remain a challenge for ophthalmologists worldwide, due to their

associated risk of corneal blindness. In this preliminary case serie we investigate of a

combination of autologous platelet-rich plasma and autologous thrombin serum, as an

autologous platelet gel for stimulating the healing process in a physiological way.

This prospective study was conducted in 10 consecutive patients with severe corneal ulcers

(5 men and 5 women; average age 60).

The underlying causes of the corneal ulcers included trauma, herpes simplex infection,

severe dry eye, neurotrophic keratitis, or systemic disease (see case distribution in Figure 1).

Autologous platelet-gel grafting was performed in all patients between June 2021 and June

2022, and the average follow-up 8 was months

All patients were treated with an autologous platelet gel obtained by combining RegenPRP(platelet rich plasma)

and ATS(autologous thrombin serum). 

The resulting fibrin membrane was applied under an operating microscope as a plug to seal

the defect in 4 cases, as an overlay to cover the entire cornea, limbus and conjunctiva in 2

cases, and as a combination of the two methods in 4 cases.

Healing was achieved after an average period of 10 days (D7-D22) for all cases. The lens was

removed after resorption of the membrane. There were no repeat procedures, except for

one patient due to partial re-epithelization. Complete healing was achieved after the second

procedure.

Patients were monitored with clinical examination and AS-OCT

(anterior Segment – OCT) at each visit.

The mean final visual acuity improved in all cases from 0.034 [0.01-0.05] to 0.216 [0.05-0.4].

In our study, complete healing was achieved in all the patients, with no recurrence over the

follow-up period extended from 2 to 14 months. A subjective improvement of anterior

segment irritation and pain was reported by 90% of patients from day 1 post-surgery.

PRP-ATS is a simple and straightforward surgical technique which should form part of

the therapeutic arsenal for ocular surface diseases. However, the technique’s indications

need to be further clarified, as it cannot correct all secondary conditions associated with

limbal destruction. The autologous combination between platelet-rich plasma and thrombin

serum as a platelet gel has proved healing properties in the repair of corneal ulcers and the

ocular surface, although a largest randomized controlled clinical study needs to be

performed for validating these preliminary outcomes.