Autologous fibrin membrane vs a patch for management of corneal perforations

Poster Details

First Author: J.Alio SPAIN

Co Author(s):    A. Rodriguez              

Abstract Details

Purpose:

To report the use of Autologous Fibrin Membrane and E-PRP clot to seal corneal perforations related to different severe corneal ulcerative diseases.

Setting:

Vissum Corporacion Alicante, Spain

Methods:

A total of 11 patients with corneal perforation were treated. Both autologous Fibrin Membrane and E-PRP clot were prepared with the patient’s own blood just before surgery. 10-0 Nylon was used to suture the fibrin membrane to the 180ŗ inferior conjunctiva. Solid platelet rich plasma clots (E-PRP solid) were then introduced onto the corneal perforation and the epithelial debrided area underneath the fibrin membrane. Further stitches were used to fixate the fibrin membrane to the rest of the conjunctiva. At the end of the procedure, a temporal partial tarsorrhaphy was performed. In the postoperative the patients received systemic antibiotics and non steroidal anti-inflammatory medication. Patients were observed daily for the following 10 days. The minimum postoperative follow-up was 2 months.

Results:

The autologous fibrin membrane obtained was circular with a diameter between 18 and 22mm and a thickness of approximately 1mm. With this shape and size the fibrin membrane was perfectly manageable and suitable for applying to the damaged ocular surface. After the procedure all cases of corneal perforation were sealed. Fibrin membrane was present between the eyelids for the first 5 days, and then gradually disappeared. No evidence of infection or inflammation was detected. Manual tonometry evidenced acceptable levels of ocular tonus in all cases from day 3 after the surgery. No patients reported pain, discomfort or any subjective symptoms. After 7 days the temporal tarsorrhaphy was removed and the ocular surface inspected with no evidence of leakage. After 2 months follow-up there was no evidence of relapses or perforations. Due to the severity of the corneal diseases corneal grafting was performed in 8 of the 10 cases.

Conclusions:

The combined use of Autologous Fibrine Membrane and E-PRP clot can be considered as a safe and effective alternative for the closure of corneal perforations to the traditional amniotic membrane transplantation procedure. This new technique can be considered as a temporary measure until the conditions of the cornea allows a definite intervention. FINANCIAL DISCLOSURE?: No