Plasma rich in growth factors as an adjuvant agent in non‐penetrating deep sclerectomy

Abstract

AbstractPurpose: To evaluate the utility and safety of plasma rich in growth factors (PRGF) eye drops in the postoperative treatment of non‐penetrating deep sclerectomy (NPDS).Methods: Retrospective case–control study, including open‐angle glaucoma patients. Cases were consecutively recruited, and used topical PRGF for 4 months after NPDS. Historical controls were patients who had undergone the same technique immediately before the start of the study (without PRGF). Prior to surgery, intraocular pressure (IOP), the number of topical hypotensive medications, and visual field mean deviation (MD) were registered. Postoperatively (1 week, 3 and 6 months), those three variables were also analysed, as well as complications, manipulations and reinterventions.Results: Preoperatively, the PRGF group (n = 37) and the control group (n = 49) were similar in age (70.9 ± 10.0 vs. 71.5 ± 10.7 years; p = 0.68), IOP (23.0 ± 9.0 vs. 20.6 ± 10.2 mmHg; p = 0.26), MD (−15.0 ± 8.8 vs. −15.9 ± 7.8 dB; p = 0.76) and the number of hypotensive medications (2.8 ± 0.9 vs. 2.7 ± 0.8; p = 0.40). IOP significantly decreased at all follow‐up visits in both groups, compared to preoperative values. That reduction was greater at 6 months with PRGF (p < 0.01): 10.9 ± 4.3 mmHg (−52.6%) versus 15.0 ± 8.0 mmHg (−27.2%). In the final analysis, the number of drugs similarly reduced in both groups (p = 0.32). MD showed no significant differences. Surgical complications were observed in 12 control eyes (25%) and 5 eyes (14%) treated with PRGF (p = 0.06). No complications related to the use of PRGF were identified. The needling rates were 9.4% and 5.9% in PRGF and controls, respectively (p = 0.58). Three eyes (6.3%) required further glaucoma surgery in the control group, and 1 (2.7%) in the PRGF‐group (p = 0.78). The final complete success rate was higher with PRGF: 83.8% vs 60.4%.Conclusions: Postoperative PRGF reduced IOP and complications rate in the mid‐term after NPDS, thus it may be considered as a possible safe adjuvant agent to achieve surgical success.