Autologous Fibrin Membrane Combined With Solid Platelet-Rich Plasma in the Management of Perforated Corneal Ulcers A Pilot Study

被引:55
作者
Alio, Jorge L. [1 ,2 ,5 ]
Rodriguez, Alejandra E. [3 ]
Martinez, Lorena M. [4 ]
Luque Rio, Alvaro [4 ]
机构
[1] Vissum Corp Oftalmol, Dept Cornea Surg, Alicante 03016, Spain
[2] Vissum Corp Oftalmol, Dept Refract Surg, Alicante 03016, Spain
[3] Vissum Corp Oftalmol, Res & Dev, Alicante 03016, Spain
[4] Vissum Corp Oftalmol, Alicante 03016, Spain
[5] Univ Miguel Hernandez, Div Ophthalmol, Alicante, Spain
关键词
OCULAR SURFACE RECONSTRUCTION; AMNIOTIC MEMBRANE; GROWTH-FACTORS; PENETRATING KERATOPLASTY; OPHTHALMOLOGY; GRAFTS;
D O I
10.1001/jamaophthalmol.2013.2474
中图分类号
R77 [眼科学];
学科分类号
100212 [眼科学];
摘要
Importance: The combined use of autologous fibrin membrane and the eye platelet-rich plasma (E-PRP) clot could be considered as a new surgical alternative for the closure of corneal perforations. Objective: To evaluate the use of autologous solid platelet-rich plasma in combination with an autologous fibrin membrane as a surgical alternative for wound closure in perforated corneal ulcers. Design: Both the fibrin membrane and the E-PRP clot were prepared with the patient's own blood just before the operation. Nylon stitches were used to fixate the fibrin membrane to the conjunctiva and then the E-PRP clot was placed over the corneal perforation, underneath the fibrin membrane. A temporal partial tarsorrhaphy was performed at the end of the procedure. We conducted postoperative monitoring for 3 months. Setting: Vissum Corporacion Oftalmologica, Alicante, Spain. Participants: Eleven patients with perforated corneal ulcers. Intervention: Surgical alternative for the closure of corneal perforation. Main Outcomes and Measures: Corneal biomicroscopy, fluorescein test, digital tonometry. Results: In all cases the corneal perforation was sealed. The fibrin membrane was present over the corneal surface for the first 3 to 5 days and then gradually disappeared. No evidence of infection or inflammation was detected. Digital tonometry confirmed acceptable levels of ocular tonus in all cases from day 2 after the operation. No patients reported pain, discomfort, or other symptoms, and no complications were observed. After 3 months' follow-up, there was no evidence of relapses or perforations. Corneal grafting was eventually performed in 7 of the 11 cases. Conclusions and Relevance: The combined use of autologous fibrin membrane and E-PRP clot is a safe and effective surgical alternative for the closure of corneal perforations. This technique can be considered as a temporary measure until the condition of the cornea permits definite intervention.
引用
收藏
页码:745 / 751
页数:7
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