The Autologous Platelet-Rich Fibrin (Prf) Membrane: A New Therapeutic Weapon In Refractory Corneal Ulcers (Experience Of The Ophthalmology Department At Chu Hassan Ii Of Fez)

Corneal ulcers can present in multiple clinical and pathogenic forms. In some cases, they represent a serious sight-threatening condition when the response to standard treatment is incomplete or absent. The use of an autologous platelet-rich fibrin (PRF) membrane is an intersting therapeutic alternative.

Our purpose was to evaluate the effectiveness of the PRF membrane in the treatment of refractory corneal ulcers.

This is a prospective, single-center study involving 40 patients with refractory corneal ulcers treated with PRF membrane coverage (in combination with an appropriate etiological treatment) at the Ophthalmology Department of University Hospital Hassan II of Fez over a period of six months, from May 2024 to November 2024.

All patients were informed about the surgical procedure.

The PRF membran is prepared in the operating room. venous blood was drawn into dry tubes and immediately centrifuged at 3500 revolutions per minute for 15 minutes. At the end of centrifugation, the intermediate phase forms the PRF clot, and the membrane is obtained by gently compressing this clot. Under topical anesthesia, the membrane was placed without sutures with a therapeutic lens in some cases or sutured in others.

The average ulcer size was 5 mm. The mean resorption time of the membrane was five days , depending mainly on gender and the patient’s medical history .The etiologies were diverse : Neurotrophic aseptic ulcers (10 cases), Allergic ulcers (2 cases), Immunological ulcers (9 eyes) Infectious keratitis in 20 cases .

In aseptic ulcers, healing was achieved in 19 cases, with one case of neurotrophic keratitis with a total ulcer showing no healing. Healing occurred within an average of 10 days, with an improvement of four lines in visual acuity (VA). In abscessed ulcers, healing was achieved in 16 cases, taking an average of 15 days with a two-line improvement in VA. The average corneal thickness in the ulcerated area increased from 350U to 500U.

The PRF membrane is a purely autologous biomaterial that enables a prolonged release of growth factors and trophic elements for the cornea at high concentrations.Compared to other therapeutic alternatives, PRF membrane offers immediate and easy availability, especially in urgent situations, and is purely autologous, eliminating the risk of rejection or vascularization. It is rapidly resorbed and integrated, and it is also cost-effective.

Regenerative medicine has garnered increasing scientific interest over the past decades. Its applications have been successfully implemented in various fields. Further studies with longer clinical follow-ups and stricter methodologies are necessary to confirm the reliability of these results.