Autologous Platelet Rich Plasma Versus Autologous Serum Eye drops in Treatment of Severe Dry Eye Disease

• Published in: International journal of medical arts Vol. 4; no. 8; pp. 2542 - 2549
• Main Authors: Mohammad, Esraa, lamie, nashwa, ismail, amira, mansour, mona
• Format: Journal Article
• Language: English
• Published: Al-Azhar University, Faculty of Medicine (Damietta) 05-09-2022
• Subjects: autologous serum; conjunctival hyperaemia; conjunctival impression cytology; corneal fluorescein staining; dry eye; platelet rich plasma; schirmer’s test; tear break-up time
• ISSN: 2682-3780; 2636-4174; 2682-3780
• DOI: 10.21608/ijma.2022.152958.1490

Background: Dry eye disease [DED] results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Biological tear substitutes, a blood derivative, demonstrated good efficacy in improvement of symptoms and ocular surface staining reduction in patients with moderate-to-severe dry eye disease.  Aim of the work: To evaluate the efficacy of autologous serum [AS] eye drops [20%], platelet rich plasma [PRP] eye drops [20%], for treatment of severe DED and comparing their results with each other.Patients and methods: A prospective comparative study included 120 eyes of 60 patients with severe DED aged 18 - 67 years. Patients divided into 2 groups according to treatment protocol: Group I:  60 eyes of 30 patients treated with autologous serum eye drops, Group II: 60 eyes of 30 patients treated with autologous platelet rich plasma eye drops. They underwent a comprehensive ophthalmic examination, evaluation of best corrected visual acuity [BCVA], tear break-up time [TBUT], Schirmer’s test, corneal fluorescein staining [CFS; oxford grading scale], and level of Conjunctival hyperaemia [Efron grading scale] during 6 weeks of treatment. Conjunctival impression cytology [CIC] studied before and after treatment.Results: Statistically significant larger improvement in BUT [p=0.001], Schirmer’s test [p < 0.001] and significantly larger reduction of CFS [p < 0.001] in Group II compared to Group I at six weeks after treatment. Likewise, a significant improvement of Nelson grading of CIC [p =0.04] was found in Group II. Greater reduction of conjunctival hyperaemia but not statistically significant [p = 0.275], also the improvement in BCVA [log MAR], [p=0.242], in Group II compared to Group I at six weeks after treatment.Conclusion: PRP eye drops induces a more significant improvement in different DED signs than AS in treatment of severe dry eye disease.