Sub Conjunctival & Lacrimal Gland Injection With Platelet Rich Plasma (E-Prp) In Treating Chronic Unresponsive Dry Eye Disease

To evaluate the effectiveness of injecting autologous platelet rich plasma (PRP) sub-conjunctival and in the lacrimal gland for treating chronic unresponsive dry eye disease and increasing lacrimal glands tear production

A prospective, interventional, non-randomized study conducted at VISSUM Ophthalmology Institute in Alicante, Spain .

A prospective, interventional, non-randomized study conducted on 12 Adult patients (10 females and 2 males) with moderate to severe chronic DED (for 6 months or more) according to the Dry Eye severity grading scheme proposed by the Dry Eye Work Shop (DEWS). All selected cases underwent pre and post-operative tear film evaluation tests (dry eye protocol); Schirmer test, tear break up time test (TBUT), corneal staining according to oxford classification and OSDI before and after injection. Post-operative visits were on 1st day after injection, after 1 week, after 6 weeks and after 3 months. Where all have been injected once with 1 ml of concentrated PRP plus 60-70 µl calcium chloride for activation in the lacrimal. gland and sub-conjunctiva

In this study PRP injection in sub-conjunctival and lacrimal glands shows improvement in all objective parameters of evaluating tear film volume and stability. All patients have shown significant decrease in corneal staining according to Oxford grading where all patients reach grade zero. A significant improvement in ocular surface status. improvement in Schirmer test value from 0.7±2.1 to 9.6±1.4, TBUT value from 5±0.5 to 11±1.4 s and decrease in ocular surface staining and ocular discomfort after PRP injection.

Injecting PRP in the lacrimal gland and sub-conjunctival is a safe, effective and promising procedure in treating chronic unresponsive dry eye in improving tear volume and the quality of lacrimal glands’ tear production with absence of any side effects or complications