The Role Of Platelet-Rich Fibrin Membrane (Prfm) In The Management Of Infectious Corneal Ulcer Perforations: A Case Series Of 15 Eyes
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR230 | Type: Poster | DOI: 10.82333/273p-m870
Authors: Prof. Dr Hassan Moutei 1 , Dr Fadila Lachkar* 1 , A/Prof. Fouad Chraibi 1 , A/Prof. Meriem Abdellaoui 1 , A/Prof. Idriss Benatiya 1
1Ophtalmology,Hassan II university Hospital,Fez,Morocco
Purpose
Corneal perforations secondary to infectious ulcers are a sight-threatening emergency requiring urgent surgical intervention. Limited donor tissue availability in resource-constrained settings necessitates alternative approaches. Platelet-rich fibrin membrane (PRFm), an autologous biomaterial rich in VEGF, TGF-β, and PDGF, offers adhesive, antimicrobial, and regenerative properties. This study evaluates its anatomical and functional outcomes as a primary surgical strategy in small infectious corneal perforations.
Setting
A prorospective case series of 15 eyes from 15 patients
Methods
A prorospective case series of 15 eyes from 15 patients was conducted at the Department of Ophthalmology, Hassan II University Hospital, Fès, Morocco. All perforations measured 2–3 mm in diameter (mean 2.4 ± 0.3 mm). Iris prolapse was present in 8 cases (53.3%) and flat anterior chamber in 11 eyes (73.3%) at presentation. PRFm was prepared by standardized centrifugation of autologous venous blood and secured with 10-0 nylon sutures, combined with intensive antimicrobial therapy. Outcomes included globe integrity, IOP, epithelial healing assessed by AS-OCT, BCVA, and complications at 1 week, and 1 month.
Results
Fifteen eyes of 15 patients (mean age 52.3 ± 14.7 years) were included. Infectious etiologies were bacterial in 9 cases (60%), fungal in 6 cases (40%).
Primary corneal sealing was achieved in 8/15 eyes (53,3%) within the first postoperative week, confirmed by negative Seidel test and AS-OCT membrane apposition. Anterior chamber reformation and IOP normalization were achieved in all sealed cases within a mean of 5.8 ± 2.1 days. Complete re-epithelialization was observed in 6/8 sealed eyes (75%) at a mean of 12.4 ± 3.1 days. BCVA improved by ≥2 Snellen lines in 4 eyes (50 %) at 1-month follow-up.
Conclusions
PRFm appears to be a promising and accessible surgical option for small infectious corneal perforations of 2–3 mm, with encouraging anatomical outcomes in infectious etiologies. These preliminary findings support PRFm as a potential temporizing measure pending definitive keratoplasty in resource-limited settings. Prospective multicenter studies with larger cohorts are needed to better establish its efficacy, safety profile, and optimal indications.