Evans Adam G, Ivanic Mirjana G, Botros Mina A, Pope Rand W, Halle Briana R, Glassman Gabriella E, Genova Rafaella, Al Kassis Salam
Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN, 37208, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO, 63110, USA.
Arch Dermatol Res. 2021 Nov;313(9):711-727. doi: 10.1007/s00403-020-02173-z. Epub 2021 Jan 12.
Intradermal injection of autologous platelet-rich plasma (PRP) is a non-surgical cosmetic therapy to rejuvenate the periorbital area pathologies of wrinkles, periorbital hyperpigmentation (POH), and photoaging. The past decade has seen the adoption of this novel therapy around the world. This is the first systematic review and meta-analysis evaluating PRP treatment of periorbital pathologies. This is a PRISMA compliant review that includes a comprehensive search of the databases Cochrane Library, Ovid Medline, Ovid Embase, and clinicaltrials.gov. The search was performed in June 2019 to obtain all peer-reviewed articles published in English that describe the application of PRP to periorbital pathologies. A meta-analysis of patient satisfaction was performed for randomized controlled trials. Nineteen studies treating 455 patients (95% female, age range 28-60) were included. Studies were categorized based on reported outcomes: wrinkles (11 studies), POH (7 studies), and photoaging (6 studies). Patients were treated a mean of 3 times (range 1-8) in mean intervals of 23 days (range 14-56 days). Follow-up averaged 3 months (range 1-6 months). Meta-analysis of 3 randomized controlled clinical trials (RCTs) shows that patients treated with PRP have increased satisfaction above controls of saline, platelet-poor plasma, mesotherapy, and as an adjunct to laser therapy (overall effect p = 0.001, heterogeneity I = 64%). PRP treatment of periorbital area pathologies results in histologic improvements of photoaging, subjective satisfaction score increases, and blind evaluator assessments of rejuvenated skin appearance. Future studies are needed to address limitations of the current literature and should include long-term follow-up, delineation of the POH etiology that is treated, RCTs with low risk of bias, and be absent conflicts of interest or industry sponsors.Trial registration: Prospero Systematic Review Registration ID: CRD42019135968.
皮内注射自体富血小板血浆（PRP）是一种非手术美容疗法，用于改善眶周区域皱纹、眶周色素沉着（POH）和光老化等病理状况。在过去十年中，这种新型疗法已在全球范围内得到应用。这是第一项评估PRP治疗眶周病理状况的系统评价和荟萃分析。这是一项符合PRISMA标准的评价，包括对Cochrane图书馆、Ovid Medline、Ovid Embase和clinicaltrials.gov数据库的全面检索。检索于2019年6月进行，以获取所有以英文发表的、描述PRP在眶周病理状况中应用的同行评审文章。对随机对照试验进行了患者满意度的荟萃分析。纳入了19项治疗455例患者（95%为女性，年龄范围28 - 60岁）的研究。研究根据报告的结果进行分类：皱纹（11项研究）、POH（7项研究）和光老化（6项研究）。患者平均接受3次治疗（范围1 - 8次），平均间隔23天（范围14 - 56天）。随访平均为3个月（范围1 - 6个月）。对3项随机对照临床试验（RCT）的荟萃分析表明，接受PRP治疗的患者比接受生理盐水、贫血小板血浆、中胚层疗法治疗的对照组以及作为激光治疗辅助手段的对照组的满意度更高（总体效应p = 0.001，异质性I = 64%）。PRP治疗眶周区域病理状况可导致光老化的组织学改善、主观满意度评分增加以及对皮肤外观年轻化的盲法评估。未来的研究需要解决当前文献的局限性，应包括长期随访、明确所治疗的POH病因、偏倚风险低的RCT，且不存在利益冲突或行业赞助。试验注册：Prospero系统评价注册编号：CRD42019135968。
