Injectable platelet-rich fibrin for corneal epithelium healing: An in vivo confocal microscopy study after crosslinking.

PURPOSE: This study was conducted to investigate the effect of injectable platelet-rich fibrin on the recovery of compromised epithelium due to crosslinking treatment.

METHODS

In this comparative study, the epithelial closure rates and in vivo confocal biomicroscopy results of 26 patients with keratoconus who underwent subconjunctival injection of injectable platelet-rich fibrin near the limbus after epithelium-off corneal crosslinking treatment were compared with those of 25 patients who did not receive the injection of injectable platelet-rich fibrin.

RESULTS

The average time to epithelial defect closure in the injectable platelet-rich fibrin group was 2.76 ± 0.90 days compared to 3.56 ± 0.86 days in the non-injectable platelet-rich fibrin group (p=0.003). At the end of the 1st month, the mean subbasal nerve plexus density was 1.26 ± 1.61 nerves/mm2 in the injectable platelet-rich fibrin group, whereas it was 0.72 ± 0.89 nerves/mm2 in the non-injectable platelet-rich fibrin group (p=0.016). By the 3rd month, the density increased to 3.42 ± 1.13 nerves/mm2 in the injectable platelet-rich fibrin group and 2.36 ± 1.15 nerves/mm2 in the non-injectable platelet-rich fibrin group (p=0.002). Similarly, the anterior stromal keratocyte density at the end of the 1st month was 93.6 ± 33.5 cells/mm2 in the injectable platelet-rich fibrin group compared to 67.3 ± 26.4 cells/mm2 in the non-injectable platelet-rich fibrin group (p=0.001). By the end of the 3rd month, the density increased to 255.2 ± 45.7 cells/mm2 in the injectable platelet-rich fibrin group and 222.1 ± 43.6 cells/mm2 in the non-injectable platelet-rich fibrin group (p=0.011). In the non-injectable platelet-rich fibrin group, one patient developed a sterile infiltrate at the end of the 1st week, whereas no complications were observed in the injectable platelet--rich fibrin group.

CONCLUSION

Subconjunctival injectable platelet-rich fibrin application is an effective and safe method for corneal epithelial healing after crosslinking treatment.