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. 2023 Jul;43(7):2341-2348.
doi: 10.1007/s10792-023-02631-3. Epub 2023 Jan 24.

SMILE lenticule versus amniotic membrane graft (AMG) augmented with platelet-rich plasma (PRP) for the treatment of perforated corneal ulcer

Mohamed M Mahdy Tawfeek  1 , Hanan Mohamed Abdel Hamid Ahmed  2 , Ashraf Bor'i  3 , Ahmed M Nashaat Ali Rady  4
Affiliations

SMILE lenticule versus amniotic membrane graft (AMG) augmented with platelet-rich plasma (PRP) for the treatment of perforated corneal ulcer

Mohamed M Mahdy Tawfeek et al. Int Ophthalmol. 2023 Jul.

Abstract

Purpose: 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.

Patients and methods: This is a comparative retrospective study that included 40 eyes with medium-sized corneal perforations, 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).

Results: 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.

Conclusion: 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.

Keywords: AMG; PRP; Perforated corneal ulcer; Stromal lenticule obtained from small-incision lenticule extraction (SMILE) surgery.

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