ESCRS - PO155 - Surgical Management Of Complications Of Corneal Alkali Injury With Autologous Fibrin Membrane And Solid Platelet - Rich Plasma (E-Prp)

Surgical Management Of Complications Of Corneal Alkali Injury With Autologous Fibrin Membrane And Solid Platelet - Rich Plasma (E-Prp)

Published 2024 - 42nd Congress of the ESCRS

Reference: PO155 | Type: Case Report | DOI: 10.82333/kfrj-ad39

Authors: Mariami Agdgomelashvili* 1 , Jorge L Alio 2

1Research,Development and innovation department,Vissum Grupo Miranza,Alicante,Spain, 2Research,Development and innovation department,Vissum Grupo Miranza,Alicante,Spain;Department of ophthalmology,universidad Miguel Hernandez,Alicante,Spain

Purpose

To report the outcome of the non-healing corneal ulcer caused by alkali chemical injury. For the treatment we utilized a safe,effective and innovative surgical technique using
an autologous fibrin membrane combined with solid platelet rich plasma (E-PRP) clot, which could be easily prepared with the patient’s own blood before the operation.

The main goal of this treatment is to gain stability of the ocular surface and to get the cornea ready for the next appropriate intervention.

Setting

 Vissum  Grupo Miranza, Alicante, Spain.

Report of case

A 10-year-old girl suffered from non-healing corneal ulcer during 2 months, caused by alkali chemical injury on her left eye. Despite of conservative treatment she was prescribed, there wasn’t significant Improvement noted. She complained of severe burning in her left eye, foreign body sensation, photophobia, tearing and blurriness. Clinical examinations showed 40% corneal epithelial defect, that involved the underlying stroma and 360 degrees limbal stem cells deficiency. Pre-operativelyher  UDVA was 1.0 on the right eye and CF 1m  on the left eye with no improvement on subsequent refraction. Intraocular pressure was measured by Goldmann applanation tonometer was 12mmHg on the right eye and 11mmHg on the left eye.

We performed innovative, safe and effective surgical treatment using autologous fibrin membrane combined with and E-PRP clot, which was prepared preoperatively with the patient's own blood, which was fixated with Nylon stitches to the conjunctiva.E-PRP clot was placed  under the fibrin membrane over the corneal ulcer. We performed temporal partial tarsorrhaphy and observed the patient during 3 months. After 5 days post-operativery the fibrin membrane gradually dissipated. The sutures from the eyelid were removed on the 10th postoperative day.  There  was significant improvement of her clinical overall status. The cornea was completely healed. After 3 months postoperatively there was remarkable imporovement, UDVA for left eye improved from CF 1m to 0,3.

Conclusion/Take home message

This case shows the efficacy and safety of a surgical treatment with combined use of autologous fibrin membrane and E-PRP clot

in a patient with non-healing corneal ulcer caused by alkali burn. This technique could be used as a temporary treatment to get the cornea ready for the next appropriate intervention