Autologous platelet gel as adjunctive therapy for severe corneal ulcers: a pilot study

Purpose: To explore the clinical feasibility and potential efficacy of a novel autologous platelet gel (APG) formulation—combining platelet-rich plasma (PRP) and autologous thrombin serum (ATS)—for the treatment of severe corneal ulcers with persistent epithelial defects refractory to conventional medical therapies. Methods: This pilot exploratory study describes a prospective case series of 10 patients (mean age 60 years) presenting with nonhealing corneal ulcers of various etiologies. All patients received APG applied as a single overlay or plug under a bandage contact lens, along with supportive therapy (lubricants, antibiotics, mydriatics, and PRP eye drops). Outcome measures included epithelial healing time, corrected distance visual acuity (CDVA), and AS-OCT imaging. Descriptive analysis was used due to the small sample size. Results: Complete epithelial healing was observed in all cases within a mean of 10 days (range 7–22 days). One patient required a repeat application due to incomplete healing after the initial procedure. CDVA improved from 0.034 ± 0.05 to 0.216 ± 0.4 LogMAR. No adverse events or ulcer recurrence were reported during a mean follow-up of 8 months (range 2–14 months). Conclusion: This preliminary case series suggests that APG may represent a potential adjunctive therapy for promoting corneal healing in severe, treatment-resistant ulcers. However, due to the small sample size, heterogeneity of etiologies, lack of a control group, and variable follow-up, the evidence should be regarded as exploratory and hypothesis-generating. Larger, stratified, and controlled clinical trials are warranted to confirm safety and effectiveness relative to established therapies.