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

In this study, ten patients affected by severe corneal ulcers from different origins were treated with autologous platelet gel and we investigate the healing process and the visual acuity.

All patients were treated with an autologous platelet gel: PRP-ATS (obtained by combining the platelet rich plasma (PRP) and Autologous thrombin serum(ATS) prepared with RegenATS®, 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.   On all cases no sutures were used, only bandage contact lens. Patient were discharged with a sterile eye patch for 3 days, and a prescription for the following treatment.

Healing was achieved after an average period of 10 days (D7-D22). There was one repeat procedure due to partial re-epithelization with Complete healing after the second procedure.

The mean final visual acuity improved in all cases from 0.034 [0.01-0.05] to 0.216 [0.05-0.4]. 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 (symptoms) was reported by 90% of patients from day 1 post-surgery. 

A stabilisation or reduction of the neovascular invasion was obtained in 3 weeks. The analysis of this parameter is beyond the scope of this paper.

No ulcer recurrence was reported by the end of the follow-up period.

The 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.