Use of autologous platelet-rich plasma in the treatment of dormant corneal ulcers

Abstract

Purpose: To investigate the potential role of autologous platelet-rich plasma in promoting healing in dormant corneal ulcers.

Design: Prospective, consecutive, interventional, noncomparative, nonrandomized, observational study.

Participants: Forty eyes of 38 patients with dormant corneal ulcers.

Methods: Autologous platelet-rich plasma was used in a total of 40 eyes with dormant corneal ulcers divided into 2 groups: group I, 26 eyes treated with topical eyedrops of autologous platelet-rich plasma (12 neurotrophic, 9 herpetic, and 5 immunological ulcers), and group II, 14 eyes treated surgically with a solid clot of autologous platelet-rich plasma combined with amniotic membrane transplantation in perforated corneas or with impending perforation. The treatment was used in patients with chronic nonhealing ulcers (mean, 2 years of evolution) that had been unresponsive to conventional topical therapy. Autologous blood from each patient was obtained by venipuncture, and platelet-rich plasma was prepared from each blood sample without additives.

Main outcome measures: Ulcer size, inflammation, healing, visual acuity, and patient's subjective symptoms.

Results: Autologous platelet-rich plasma promoted healing of ulcers. In group I, 13 eyes healed, 11 eyes improved significantly, and 2 eyes showed no change. In group II, 10 eyes healed and 4 eyes improved significantly. Inflammation and subjective symptoms, particularly pain, improved in all patients. Vision remained stable or improved in all cases.

Conclusion: Autologous platelet-rich plasma promoted healing of dormant corneal ulcers even in eyes threatened by corneal perforation and was accompanied by a reduction in pain and inflammation.