Study on PRP Eye-Drops and Corneal Wound Healing

A new study published in the British Journal of Ophthalmology suggests that higher amounts of growth factors were produced during corneal epithelial wound healing after four weeks of platelet-rich plasma (PRP) eye-drop storage at 4°C.

In a number of medical specialties, PRP has been proven to encourage biological tissues' responses to wound healing. Topical PRP therapy has been used in the field of ophthalmology to treat a variety of corneal diseases, including:

• Acute hydrops for keratoconus
• Symptomatic dry eye
• Ocular surface syndrome following laser in situ keratomileusis (LASIK)
• Persistent corneal epithelial defect
• Recurrent corneal erosion
• Dormant corneal ulcers
• Limbal stem cell deficiency

In this study, Yuichi Okumura and colleagues investigated the effectiveness and sterility of autologous serum (AS) eye drops with preserved PRP eye drops for the treatment of corneal epithelial wounds.

Peripheral blood was drawn from six healthy participants and kept at 4°C to create PRP and AS eye-drops. During storage for up to 4 weeks, platelet and leukocyte counts, levels of transforming growth factor (TGF)-1, epidermal growth factor (EGF), and fibronectin were measured. 4-week post-storage sample cultures were used to determine sterility. The effectiveness of PRP, AS, and phosphate-buffered saline (PBS) eye drops was evaluated using corneal epithelial wound healing tests in vitro and in vivo, and wound areas were monitored every three hours under a microscope.

Key Findings

• PRP had higher platelet and lower leucocyte counts on the day of preparation than whole blood.
• After storage, PRP eyedrops had much greater amounts of TGF-1, EGF, and fibronectin than AS eyedrops.
• PRP eye-drops used the day of preparation dramatically accelerated corneal epithelial wound healing in vitro and in vivo as compared to PBS.
• In addition, compared to PBS and AS eyedrops, PRP eyedrops held for 4 weeks significantly accelerated corneal wound healing.

In conclusion, in addition to retaining sterility, PRP eye-drops held at 4°C for four weeks stimulated corneal epithelial wound healing with greater levels of growth factors than those seen in AS eye-drops. This finding suggests that this preparation addresses unmet medical requirements in the treatment of refractory keratoconjunctivitis epithelial diseases.

Reference

Okumura, Y., Inomata, T., Fujimoto, K., Fujio, K., Zhu, J., Yanagawa, A., Shokirova, H., Saita, Y., Kobayashi, Y., Nagao, M., Nishio, H., Sung, J., Midorikawa-Inomata, A., Eguchi, A., Kuwahara, M., & Murakami, A. (2022). Biological effects of stored platelet-rich plasma eye-drops in corneal wound healing. In British Journal of Ophthalmology (p. bjo-2022-322068). BMJ. https://doi.org/10.1136/bjo-2022-322068