Objective: To evaluate use of autologous platelet-rich plasma (PRP) eye drops for the treatment of severe dry eye disease.

Materials & Method: This is a retrospective study conducted at a tertiary eye care centre.  30 patients with severe dry eye disease (DED) were included in this study. Data obtained from medical records of patients. Following information noted from medical records. Type of dry eye as evaporative DED (EDED) or aqueous deficient DED (ADDED). Following information were noted before treatment with PRP eye drops and on each follow up visits; OSDI score(Subjective symptoms), Corneal Fluorescein Staining (CFS), Tear Film Breakup Time (TBUT) , Tear Meniscus Height (TMH) and Schirmer’s score (SCH 1). Follow up done at 1 week, 1 month, 3 month and final follw up done at 6 months.

Results: Out of 30 cases 19 (63.3 %) were women, and 11 (36.6 %) were men.16 (53.3 %) had EDED, while 14 (46.6%) had ADDED. 6 months of monotherapy with autologous PRP resulted reduction in dry eye symptoms in 28 (93.3 %) cases. CFS decreased in 23 (76.6 %) patients, TBUT improved in 26 (86.6%) patients, tear meniscus height improved in 24 (80.0%) patients and schirmers score improved in 16 (53.3 %) patients.

Conclusion:  Autologous PRP is a effective treatment to improve sigh and symptoms of dry eye disease.

1. Sahai A, Malik P. Dry Eye: Prevalence and attributable risk factors in a hospitalbased population. Ind J Ophthalmol 2005; 53: 87-91.
2. Gupta N, Prasad I, Jain R, D’Souza P. Estimating the prevalence of dry eye among Indian patients attending a tertiary ophthalmology clinic. Ann Trop Med Parasitol 2010; 104: 247-55.
3. Basak SK, Pal PP, Basak S, Bandyopadhyay A, Choudhury S, Sar S. Prevalence of Dry Eye Diseases in hospital-based population in West Bengal, Eastern India. J Indian Med Assoc. 2012; 110: 789-94.
4. Shimmura S, Shimazaki J, Tsubota K. Results of a population based questionnaire on the symptoms and lifestyles associated with dry eye. Cornea 1999; 18: 408-11.
5. McCarty CA, Bansal AK, Livingstone PM, Stanislavsky YL, Taylor HR. The epidemiology of dry eye in Melbourne, Australia. Ophthalmology 1998; 105: 1114-9.
6. Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol 2003; 136: 318-26.
7. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol 2000; 118: 1264-8.
8. Yazdani C, McLaughlin T, Smeeding JE, Walt J. Prevalence of treated dry eye disease in a managed care population. Clin Ther 2001; 23: 1672-82.
9. Schaumberg DA, Buring JE, Sullivan DA, Dana MR. Hormone replacement therapy and dry eye syndrome. JAMA 2001; 286: 2114-9.
10. Seedor JA, Lamberts D, Bergmann RB, Perry HD. Filamentary keratitis associated with diphenhydramine hydrochloride (Benadryl). Am J Ophthalmol 1986; 101: 376-7.
11. Hussain M, Shtein RM, Sugar A, Soong HK, Woodward MA, DeLoss K, Mian SI. Long-term use of autologous serum 50% eye drops for the treatment of dry eye disease. Cornea. 2014;33(12):1245–51.
12. Pan, Q., Angelina, A., Zambrano, A., et al. Autologous serum eye drops for dry eye. Cochrane Database Syst. Rev. 8:CD009327, 2013.
13. de Paiva, C.S., and Pflugfelder, S.C. Rationale for anti-inflammatory therapy in dry eye syndrome. Arq. Bras. Oftalmol. 71:89–95, 2008.
14. Dogru, M., and Tsubota, K. Pharmacotherapy of dry eye. Expert Opin. Pharmacother. 12:325–334, 2011.
15. Blomquist, P.H. Ocular complications of systemic medications. Am. J. Med. Sci. 342:62–69, 2011.
16. Zhou, X.Q., and Wei, R.L. Topical cyclosporine A in the treatment of dry eye: a systematic review and metaanalysis. Cornea. 33:760–767, 2014.
17. Wu TE, Chen JC, Hu C, Cheng CK. Easy-to-prepare autologous platelet-rich plasma in the treatment of refractory corneal ulcers. Taiwan J Ophthalmol. 2015; 5(3):132-5.
18. Lopez-Garcia JS, Garcia-Lozano I, Rivas L, Martinez-Garchitorena J. Use of autologous serum in ophthalmic practice. Arch Soc Espanola Oftalmol. 2007; 82(1):9-20.
19. Freire V, Andollo N, Etxebarria J, Duran JA, Morales MC. In vitro effects5 of three blood derivatives on human corneal epithelial cells. Invest Ophthalmol Vis Sci. 2012; 53(9):5571-8.
20. Ribeiro MV, Barbosa FT, Ribeiro LE, Lacet CM, Lyra JM, Guedes VL, et al. Platelet-rich plasma in diabetic dry eye disease. Rev Bras Oftalmol. 2016 ;75(4):308-13.
21. Barlett JD, Keith MS, Sudharshan L, Snedecor SJ. Associations between signs and symptoms of dry eye disease: a systematic review. 2015 Sep 16;9:1719-30. doi: 10.2147/OPTH.S89700.
22. Alio JL, Arnalich-Montiel F, Rodriguez AE. The role of “Eye Platelet Rich Plasma” (E-PRP) for wound healing in ophthalmology. Curr Pharm Biotechnol. 2012;13(7):1257–65.
23. Amable PR, Carias RBV, Teixeira MVT, da Cruz Pacheco Í, Corrêa do Amaral RJF, Granjeiro JM, Borojevic R. Platelet-rich plasma preparation for regenerative medicine: Optimization and quantification of cytokines and growth factors. Stem Cell Research & Therapy. 2013;4(3):67
24. Jorge L. Alio,Alejandra E. Rodriguez, Renan Ferreira-Oliveira, Dominika Wróbel Dudzińska, Ahmed A. Abdelghany Treatment of Dry Eye Disease with Autologous Platelet-Rich Plasma: A Prospective, Interventional, Non-Randomized Study December 2017, Volume 6, Issue 2, pp 285–293
25. Ribeiro MV, Barbosa FT, Ribeiro LE, Lacet CM, Lyra JM, Guedes VL, et al. Platelet-rich plasma in diabetic dry eye disease. Rev Bras Oftalmol. 2016;75(4):308-13.
26. Alio JL¹, Colecha JR, Pastor S, Rodriguez A, Artola A. Symptomatic dry eyetreatment with autologous platelet-rich plasma. 2007;39(3):124-9. Epub 2007 Mar 19.
27. Sanchez-Avila RM¹, Merayo-Lloves J¹, Riestra AC¹, Anitua E^2,3, Muruzabal F^2,3, Orive G^3,4,5, Fernández-Vega L¹.The Effect of Immunologically Safe Plasma Rich in Growth Factor EyeDrops in Patients with Sjögren Syndrome. 2017 Jun;33(5):391-399. doi: 10.1089/jop.2016.0166. Epub 2017 Apr 4
28. Drew VJ, Tseng CL, Seghatchian J, Burnouf T. Reflections on Dry Eye Syndrome Treatment: Therapeutic Role of Blood Products. Front Med (Lausanne). 2018;5:33. Published 2018 Feb 23. doi:10.3389/fmed.2018.00033
29. Avila MY. Restoration of human lacrimal function following platelet-rich  plasma injection.  Cornea (2014) 33(1):18–21.10.1097/ICO.16 

Dr Rishi Gupta

Sankara Nethralaya