This case series described the use of a novel technique in the treatment of descemetocele. Three patients developed descemetoceles following infective keratitis with impending risk of corneal perforation. Platelet rich fibrin (PRF) membrane was prepared using 8ml of fresh venous blood sample obtained from the patient’s antecubital vein in a 10ml glass tube without anticoagulant just before the surgery. The blood sample was immediately centrifuged for 12 minutes using a centrifuge system. The fibrin clot was mechanically separated from the red blood cells and gently compressed using a custom-made PRF membrane box. In one patient two PRF membranes were used; inlay PRF to fill the corneal stromal defect and an overlay PRF to cover the whole cornea sutured to the limbus. BCL was also used to secure the transplants. The overlay PRF membranes dissolved under the BCL postoperatively, however, the inlay PRF became incorporated into the surrounding corneal tissue and epithelised. During the three-month follow-up after surgery, the central descemetocele area became thicker with scar formation and reduction in corneal vascularisation. In the two patients where only inlay membranes were used, similar incorporation of the PRF membranes and stromal thickening was observed. This article is a small series describing a novel technique for structural strengthening of cornea to add to the surgical options in descemetocele management. Larger studies are needed to validate such an approach.

Urgent therapeutic grafting of platelet-rich fibrin membrane in descemetocele.
Can ME, Can GD, Cagil N et al.
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Magdalena Popiela

Royal Gwent Hospital, Cardiff, UK.

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