Efficacy and safety of treatment of hyposecretory dry eye with platelet‐rich plasma

Abstract

Objective: To evaluate and compare the symptomatology and clinical findings in hyposecretory dry eye of the treatment with platelet-rich plasma (PRP) and artificial tears of sodium hyaluronate (SH). Methods: Blind single-centre prospective comparative randomized study including 83 patients with hyposecretory dry eye and mean age of 64.0 years. Two groups were differentiated depending on the treatment applied: 44 patients treated with PRP (PRP group), and 39 patients treated with artificial tears of SH (SH group). Changes in Schimer test, tear osmolarity, corneal and conjunctival staining, tear film break-up time (TF-BUT), conjunctival hyperaemia, dry eye-related symptoms with the Ocular Surface Disease Index questionnaire, and caliciform cell density were evaluated during 30 days of treatment.Results: Significantly larger reduction in symptomatology (p < 0.001), visual improvement (p < 0.001), reduction in hyperaemia (p < 0.001), and corneal and conjunctival staining (p < 0.001), increment of Schirmer test outcome (p ≤ 0.005), and reduction of osmolarity were found in the PRP group in both eyes compared to SH group at 15 and 30 days of treatment. Likewise, a significantly higher increment of caliciform cell density (p < 0.001) was found in the PRP group. Strong and statistically significant correlations were found in the PRP group of the change achieved in visual acuity, hyperaemia, osmolarity, and conjunctival and corneal staining with the baseline values of these variables (p < 0.001). Conclusion: PRP treatment in hyposecretory dry eye induces a more significant positive effect over symptomatology and different dry eye signs than SH, especially in moderate and severe cases.

Blood-Based Treatments for Severe Dry Eye Disease: The Need of a Consensus

“…Similar results were obtained in 25 NK patients treated by Wróbel-Dudzinska et al with PRP eye drops, with complete healing of the corneal ulcer observed in 80% of patients, while improved symptoms and visual acuity observed in all of them [118]. In a randomized clinical trial, Garcia-Conca et al compared PRP eye drops with tear substitutes in patients with hyposecretory DED [119]. Patients treated with PRP showed a significantly higher improvement in symptoms, visual acuity, conjunctival hyperaemia, corneal and conjunctival staining, Schirmer test, and tear osmolarity [119].…”

“…In a randomized clinical trial, Garcia-Conca et al compared PRP eye drops with tear substitutes in patients with hyposecretory DED [119]. Patients treated with PRP showed a significantly higher improvement in symptoms, visual acuity, conjunctival hyperaemia, corneal and conjunctival staining, Schirmer test, and tear osmolarity [119].…”

<p>Human Platelets and Derived Products in Treating Ocular Surface Diseases – A Systematic Review</p>

“…Among all studies treating dry eye diseases (DED), Avila et al 27 was designated at clinical evidence level II, and Garcia-Conca et al 28 at clinical level III. Both studies included a comparison group and used PRP eye drops.…”

Recent developments in regenerative ophthalmology

“…Pezzotta et al investigated the efficacy and safety of long-term continuous treatment with autologous platelet lysate drops in oGvHD patients with a DED score of 2-3 which had symptoms refractory to topical conventional therapy (Pezzotta et al, 2017). García-Conca et al claimed that treatment of hyposecretory DED with PRP induced a significantly more positive effect on the signs and symptoms of DED than did sodium hyaluronate, particularly in moderate and severe cases (García-Conca et al, 2019). Subsequently, Arslan et al obtained promising preliminary clinical results in a study investigating the use of subtenon injection of aPRP to treat patients with RP in terms of significant improvements in VF, mfERG values, and MP (Arslan et al, 2018).…”