Allogeneic Solid Platelet-Rich Plasma For Persistent Epithelial Neurotrophic Defects: A Protocol And Pilot Study
Published 2023 - 41st Congress of the ESCRS
Reference: PP26.03 | Type: Free paper | DOI: 10.82333/ay83-0631
Authors: Stefano Bignotti* 1 , Eliana Forbice 1 , Camillo Almici 2 , Andrea Bianchetti 2 , Francesco Semeraro 1 , Vito Romano 1
1Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, ASST Spedali Civili of Brescia ,University of Brescia ,Brescia ,Italy, 2Laboratory for Stem Cells Manipulation and Cryo- preservation, Blood Bank, Department of Transfusion Medicine, ASST Spedali Civili, Brescia,University of Brescia ,Brescia ,Italy
Purpose
We present the procedure to obtain allogeneic solid platelet-rich plasma (PRP) and its use in a pilot study of patients with persistent neurotrophic epithelial defects in combination with fibrin glue and soft contact lens
Setting
The study was conducted at the Eye Clinic of Spedali Civili of Brescia (Italy). All patients were treated in 2021
Methods
The study includes 4 eyes of 4 patients with persistent neurotrophic epithelial defects unresponsive to other therapies. PRP and thrombin were produced by the Department of Transfusion Medicine from healthy blood donors. PRP was activated in its solid form in the operating room with addition of thrombin and calcium gluconate 10% and applied on the cornea with fibrin glue and soft contact lens. Data about corneal healing time, corneal esthesiometry, visual acuity, Oxford staining score, Ocular Surface Disease Index questionnaire, and Schirmer I test, were recorded. Anterior segment optical coherence tomography and in vivo confocal microscopy were also evaluated
Results
The persistent epithelial defect healed in all patients in the first 10 days and during the follow-up there was an absence of recurrences. For all patients, there was a reduction in Ocular Surface Disease Index questionnaire score (case 1: 255 points, 273.3%; case 2: 226.3 points, 258.4%; case 3: 256 points, 269.1%; case 4: 220 points, 226.6%; mean reduction: 39.3 points, 56.85%) and Oxford staining score (case 1, 2, and 3: 3 points decrease; case 4: 2 points decrease; mean reduction: 22.75 points).
Conclusions
Allogeneic solid PRP in combination with fibrin glue may facilitate wound healing in neurotrophic persistent epithelial defects. Further prospective studies are needed to quantify its efficacy