Abstract

Purpose:To investigate whether autologous platelet-rich plasma (PRP) eye drops accelerate re-epithelialization of post-keratoplasty persistent corneal epithelial defects (PEDs).Methods:A total of 34 eyes with PEDs after keratoplasty (24 penetrating keratoplasty and 10 deep anterior lamellar keratoplasty) that were refractory to conventional medical treatments were treated with PRP eye drops every 3 hours. PRP eye drops were prepared with a low- and high-speed centrifugation method and final platelet counts were 700,000-800,000 plt/μl. The mean treatment duration for complete re-epithelialization was compared with the mean treatment duration of conventionally treated corneal defects before the PRP treatment by paired t-test. The mean treatment duration was also statistically analyzed between age groups, gender, indications for keratoplasty, and types of keratoplasty using analysis of variance (ANOVA).Results:Treatment with autologous PRP eye drops led to rapid re-epithelialization in all eyes. The mean treatment duration for complete re-epithelialization was 2.47 ± 1.21 weeks, which was significantly shorter than the mean treatment duration of conventionally treated corneal defects before PRP treatment (6.82 ± 1.24 weeks) (P = 0.0001). There was no significant correlation between re-epithelialization time and patients' age, sex, indications for keratoplasty, and techniques of corneal transplantation.Conclusion:Treatment with autologous PRP eye drops is an effective and reliable approach that accelerates re-epithelialization of post-transplantation PEDs.

Highlights

  • Persistent epithelial defects (PED) following keratoplasty may occur due to donor, recipient, and surgical technique variables and can reduce the success of corneal transplantation due to corneal opacity and vascularization, stromal melting, and secondary infection.[1]

  • Corneal wound healing is generally mediated by growth factors such as epidermal growth factors (EGFs), fibroblastic growth factors (FGFs) and platelet‐derived growth factors (PDGFs), which stimulate migration, proliferation and differentiation of the corneal epithelial cells.[2,8,9]

  • We investigated the efficacy of autologous platelet‐rich plasma (PRP) eye drops in the management of refractory cases of post‐keratoplasty PEDs

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Summary

Introduction

Persistent epithelial defects (PED) following keratoplasty may occur due to donor, recipient, and surgical technique variables and can reduce the success of corneal transplantation due to corneal opacity and vascularization, stromal melting, and secondary infection.[1]. Corneal wound healing is generally mediated by growth factors such as epidermal growth factors (EGFs), fibroblastic growth factors (FGFs) and platelet‐derived growth factors (PDGFs), which stimulate migration, proliferation and differentiation of the corneal epithelial cells.[2,8,9] Role of platelets as a rich source of growth factors has been well established in dermal wound healing.[10,11] They attach to damaged endothelium, release cytokines and growth factors to promote the healing process in the damaged region, and the healing process occurs due to alterations in the balance between promoting and inhibitory substances.[12]

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