• Healing Corneal Ulcers with Platelet-Rich Plasma
  • Ali Rezaeian,1 Aidin Amini Sefidab,2 Ali Movassagh,3 Zahra Amirkhani,4,*
    1. Medical Student, Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran.
    2. Medical Student, Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran.
    3. Medical Student, Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran.
    4. Assistant Professor, Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran.


  • Introduction: Refractory keratoconjective epithelial disorders, caused by graft-versus-host disease, corneal transplantation, Sjögren’s syndrome, and severe dry eye disease, lead to reduced visual acuity, reduced contrast sensitivity, increased susceptibility to infections, corneal perforation, and decreased quality of vision. Keratoconjunctivitis refers to an inflammatory process that involves both the conjunctiva and the superficial cornea. It can occur in association with viral, bacterial, autoimmune, toxic, and allergic etiologies. Corneal ulcers represent a severe ocular emergency with potential vision-threatening complications. The aim of this study is to evaluate the effectiveness of platelet-rich plasma (PRP) eye drops to heal corneal epithelial ulcers. PRP harbours high levels of growth factors. Platelets are known for their role in hemostasis, with which they help in preventing blood loss at sites of vascular injury. To do this, they adhere, aggregate, and form a procoagulant surface, leading to thrombin generation and fibrin formation. Platelets also release substances that promote tissue repair and influence the reactivity of vascular and other blood cells in angiogenesis and inflammation. Growth factors are released from the α-granules of the platelets. Endothelial-protein tyrosine phosphatase (PTP) is used as a complement to specialized tissue-regeneration procedures, including oral and maxillofacial surgery, orthopedics and plastic surgery. Our other aimed to determine the effectiveness of low-temperature storage on the efficacy and sterility of PRP eye-drops compared with those of autologous serum (AS) eye-drops, if practical, it may expand the clinical usage of PRP to patients ‘households. In addition, the therapeutic advantages of PRP eye-drops compared with those of standard treatments may promote their clinical application for cases of refractory keratoconjective epithelial disorders.
  • Methods: we conducted an extensive search across electronic databases, including PubMed, MEDLINE, Embase, Google Scholar, and ResearchGate, and explored the available English-language literature. The MeSH terms were " keratoconjective epithelial disorders " OR " platelet-rich plasma "; " corneal ulcers ";" ophthalmology". The articles included in this review adhere to the following criteria: they encompass studies solely focused on progress in comprehending and novel treatment approaches, and they are studies conducted in the English language within the last decades. We have used Ryan's AI in this review to screen articles, where it was done with the help of colleagues to visually separate articles using their reading as well as keyword readers.
  • Results: The importance of this study is that it shows that eye drops can be used as an effective treatment for keratoconjective epithelial disorders resistant to existing treatments. These drops not only remain sterile but also maintain higher levels of growth factors that help improve the healing process of corneal ulcers. Such findings could lead to the development of new therapies and improve the quality of life of patients with these disorders. There is an urgent need to develop effective therapeutic agents for keratoconjunctival epithelial disorders that do not respond to existing eye-drops. The stability of PRP were investigated for future clinical use. There was an increased pharmacological efficacy and a complementary degree of sterility in PRP eye-drops when stored at 4°C for 4 weeks compared with those in AS eye-drops, warranting further study of PRP eye-drops.
  • Conclusion: Another thing to note was that autologous platelet-rich plasma promoted healing of dormant corneal ulcers even in eyes threatened by corneal perforation and was accompanied by a reduction in pain and inflammation. Autologous platelet-rich plasma has been demonstrated to be effective in corneal neurotrophic ulcer treatment. The lack of preservatives, autologous quality, relative ease of its preparation, safety, and beneficial effects make PRP a promising therapeutic tool for future regenerative medicine. Despite the fact that recombinant synthetic products are available for neurotrophic ulcer treatment, those high-priced goods contain only a single growth factor. But on the other hand, some people offer low-cost PRP to make it economical. Although low-cost PRP preparation gives lower platelet concentrations than standard methods, our work shows that this preparation is effective in treating resistant non-infectious corneal ulcers.
  • Keywords: keratoconjective epithelial disorders, platelet-rich plasma, corneal ulcers, personalized medicine.