The Effect Of Subconjunctival Platelet-Rich Plasma In Refractory Dry Eye Disease

To evaluate the efficacy of subconjunctival platelet-rich plasma (PRP) therapy in the treatment of refractory dry eye and to determine the differences in efficacy and side effects between this therapy and drop therapy.

In this study, the files of patients who underwent PRP therapy for treatment-resistant dry eye disease between January 2023 and December 2023 at the Ophthalmology Clinic of Prof. Dr. Cemil Taşcıoğlu City Hospital were retrospectively analyzed.

The patients were divided into two groups: the drop therapy group and the subconjunctival treatment group. Corrected visual acuity(CVA), OSDI scores, Schirmer test results, conjunctival hyperemia, non-invasive tear breakup time(NBUT), corneal and conjunctival staining with fluorescein according to Oxford grading, and meibography findings were recorded from patient files before treatment, as well as at one and three months post-treatment. A total of 64 patients were divided into two groups:33 receiving PRP in drop form (Group1) and 31 receiving subconjunctival PRP(Group2).There was no difference between the groups in terms of age and gender.

Group1 CVA showed a statistically increase at three months compared to pre and one-month results(p=0.001).The Schirmer results didn't show a significant difference between the two groups at pre and three months post treatment.One month post-treatment,Group2 had higher Schirmer values than Group1(p=0.027).NBUT increased in both groups after treatment, but wasn't statistically significant(p>0.05).OSDI scores decreased in post treatment compared to pre-treatment values (p<0.001).At three months,the reduction was more pronounced in Group2(p=0.031).Corneal and conjunctival staining showed improvement in both groups (p<0.001).Improvement was accompanied by reduction in conjunctival hyperemia in both groups(p=0.013,p<0.001).

Both methods can be considered effective in patients with refractory dry eye. Although there is no significant difference between the two methods in terms of the evaluated parameters, subconjunctival treatment stands out with its advantages, such as enabling standardized monthly dose applications, reducing the frequency of daily drop use and the amount of drops needed, and lowering the risk of infection due to favorable sterility conditions compared to drop therapy. These features enhance both patient satisfaction and treatment compliance. Additionally, subconjunctival treatment can be considered an alternative method for the treatment of dry eye due to its feasibility in outpatient clinical settings.