Can Mehmet Erol, Dereli Can Gamze, Cagil Nurullah, Cakmak Hasan Basri, Sungu Nuran
*Department of Ophthalmology, Kecioren Training and Research Hospital, Ankara, Turkey; †Department of Ophthalmology, Faculty of Medicine, Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital, Ankara, Turkey; and ‡Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Cornea. 2016 Sep;35(9):1245-9. doi: 10.1097/ICO.0000000000000917.
To report the clinical and histopathological results of a novel autologous scaffold grafting, platelet-rich fibrin (PRF) membrane, in cases with descemetocele.
Three patients with severe corneal stromal melting and central descemetocele caused by neurotrophic keratopathy and infective keratitis underwent PRF membrane grafting on the central cornea for the prevention of imminent corneal perforation. After a quiescent 3-month period, penetrating keratoplasty and cataract extraction were performed for visual rehabilitation in 1 patient and host corneal tissue was examined histopathologically.
Pain was significantly relieved, conjunctival inflammation was markedly resolved, and the central descemetocele area became thicker with scar formation in all patients. Histopathological examination revealed fibrosis formation over the descemetocele area without any tissue gap. Newly formed tissue containing irregular corneal lamellae covered the fibrosis formation and accounted for the prevention of perforation.
Temporary PRF membrane grafting may be an alternative intervention to avoid impending corneal perforation in cases with severe descemetocele.
报告一种新型自体支架移植——富血小板纤维蛋白（PRF）膜，用于治疗角膜后弹力层膨出病例的临床和组织病理学结果。
3例因神经营养性角膜病变和感染性角膜炎导致严重角膜基质溶解和中央角膜后弹力层膨出的患者，接受了中央角膜PRF膜移植，以预防即将发生的角膜穿孔。在3个月的静止期后，1例患者接受了穿透性角膜移植术和白内障摘除术以恢复视力，并对宿主角膜组织进行了组织病理学检查。
所有患者的疼痛均明显缓解，结膜炎症显著消退，中央角膜后弹力层膨出区域因瘢痕形成而变厚。组织病理学检查显示，角膜后弹力层膨出区域形成纤维化，无任何组织间隙。含有不规则角膜板层的新形成组织覆盖了纤维化区域，起到了预防穿孔的作用。
临时PRF膜移植可能是避免严重角膜后弹力层膨出病例即将发生角膜穿孔的一种替代干预措施。
