Smile Lenticule Versus Amniotic Membrane Graft (Amg) Augmented With Platelet‑Rich Plasma (Prp) For The Treatment Of Perforated Corneal Ulcer

To evaluate the safety and efficacy of stromal
lenticule obtained from small-incision lenticule
extraction (SMILE) surgery versus amniotic membrane
graft (AMG) augmented with platelet-rich
plasma (PRP) for the treatment of perforated corneal
ulcers and compare the results between the two
groups.

This retrospective comparative interventional study was conducted on 40 eyes of 40 adult patients (≥ 18 years of age) with perforated corneal ulcers with an average size of 2–4 mm³. Patients were collected from the El-Tayseer Eye Hospital in Zagazig, Egypt, at the period from June 2021 to December 2021, where all the surgical procedures were carried out.

This retrospective comparative interventional study was conducted on 40 eyes of 40 adult patients (≥ 18 years of age) with perforated corneal ulcers with an average size of 2–4 mm³ ,which were classified into two equal groups of 20 eyes each; group (A) was treated with SMILE lenticule graft and group (B) was treated with AMG augmented with PRP. Pre- and postoperative evaluations were carried out using both slit-lamp (SL) examination and anterior segment optical coherence tomography (AS-OCT), including closure of perforation, complete healing, and best corrected visual acuity (BCVA). 

Complete closure of the perforation was achieved in both groups. However, healing was faster in the SMILE lenticule group than in the AMG
with PRP group (P < 0.05). Complete healing was achieved in both groups: 100% in SMILE lenticule group and 95% in AMG with PRP group (P > 0.05). Both groups had few insignificant complications (30% in each), which were managed.

Both methods achieved adequate healing of corneal perforations within few weeks without significant complications. However, the stromal lenticule obtained from small-incision lenticule extraction (SMILE) surgery tended to be safer with faster healing than AMG with PRP.