Symptomatic Dry Eye Treatment with Autologous Platelet-Rich Plasma

Abstract

Background: Autologous platelet-rich plasma (PRP) has been proven to be very effective on tissue regeneration and wound healing. Here we investigate the potential use of PRP in the treatment of symptomatic dry eye. Methods: Eighteen consecutive patients with symptomatic dry eye were treated with topical PRP and followed up for 1 month. Disappearance of subjective symptoms, increase in best corrected visual acuity, tear meniscus, tear breakup time, decrease in inflammation, fluorescein staining and improvement in impression cytology were measured. Results: Symptoms improved significantly in 89% of the patients, 28% improved at least 1 line of best corrected visual acuity. A significant improvement on lachrymal meniscus and conjunctival hyperemia and a decrease or disappearance of corneal fluorescein staining were observed. Impression cytology revealed a significant increase in conjunctival goblet cells. Conclusion: Treatment of patients suffering from significant dry eye symptoms with autologous RPR proved to be very effective, improving both patient symptoms and major clinical signs.

Platelet-rich plasma in diabetic dry eye disease

“…PRP is also more efficient than total plasma serum in these functions 10 . There are few studies using PRP in dry eye, 5,12 and none, to the best of our knowledge, in diabetic dry eye patients specifically.…”

Autologous platelet lysate for treatment of refractory ocular GVHD

“…22 This encouraged the use of PRGs for treating DES, corneal lesions, neurotrophic keratitis and persistent corneal epithelial defects with promising results. 22,[34][35][36][37] In fact, PRG has recently been shown to be effective in a variety of autoimmune diseases involving the eye and causing DES. 38 The prompt corneal re-epithelization triggered by the cooperation of PDGFs (such as EGF, PDGFA-B, promoting in particular cell proliferation) and the inhibitors of inflammation (for example, IL-1 receptor antagonist and inhibitors of metalloproteinases) 18,22 may explain the excellent results we obtained as early as at 30 days of treatment also in this difficult set of patients.…”

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“…The bioactive proteins include Platelet-Derived Growth Factor (PDGF), Transforming Growth Factor-beta (TGF-β), Epidermal Growth Factor (EGF), Fibroblast Growth Factors (FGF) and Insulin-like Growth Factor-1 (IGF-1), as well as cytokines, such as Platelet Factor 4 (PF4) and Cluster of Differentiation 40 Ligand (CD40L) [65][66][67]. Platelet-Rich Plasma (PRP) has been used to treat acute corneal chemical injury [68], severe dry eye [69], dormant ulcers [70], including neurotrophic, exposure and limbal deficiency with corneal ulcer after herpetic keratitis, and three case reports of corneal ulcer which included neurotrophic ulcer, exposure corneal ulcer, and limbal deficiency with corneal ulcer after herpetic keratitis [71]. Selected components of tears, serum and PRP are compared in table 2 [72,73].…”