Combined PRP and Contact Lens for Corneal Ulcer Perforation: A Case Report

Corneal ulcerations leading to perforations are severe ophthalmologic conditions posing significant risks to vision, especially in resource-limited settings where advanced surgical interventions are inaccessible. This report describes a novel, minimally invasive approach using platelet-rich plasma (PRP) therapy combined with therapeutic contact lens application to manage a corneal ulcer with perforation.

A 56-year-old female agricultural worker presented with a progressive, severe corneal ulcer with perforation that was unresponsive to conventional antiviral, antibiotic, and steroid treatments. Given the patient's refusal of invasive procedures and logistical constraints in Uzbekistan, treatment involved subconjunctival PRP injections administered on days 2, 4, and 6, along with PRP eye drops four times daily for one month. A therapeutic silicone-hydrogel contact lens was applied to protect and stabilize the ocular surface. Rapid clinical improvement was observed, with a 43% reduction in ulcer size within 24 hours and significant pain relief by day 3. Near-complete epithelialization was achieved by the one-month follow-up, with sustained visual acuity improvement from 0.1 to 0.4 maintained at two years.

Combining PRP therapy with therapeutic contact lens application is an effective, minimally invasive treatment for severe corneal ulcers with perforation, particularly advantageous in settings lacking advanced surgical options. This case highlights the potential for broader application of accessible and cost-effective therapies, warranting further clinical research to confirm efficacy and safety in larger patient populations.