Murtaza Fahmeeda, Toameh Dana, Chiu Hannah H, Tam Eric S, Somani Sohel
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Uptown Eye Specialists, Vaughan, Ontario, Canada.
Clin Ophthalmol. 2022 Jul 6;16:2199-2208. doi: 10.2147/OPTH.S367807. eCollection 2022.
To evaluate the effects of autologous platelet-rich plasma (PRP) drops for evaporative dry eye (EDE) disease from meibomian gland dysfunction (MGD).
This is a retrospective, consecutive case series of 20 eyes of 10 patients with EDE from MGD treated with PRP drops from November 2020 to November 2021 at a single outpatient clinic in Ontario, Canada. PRP drops were prepared from whole blood using a two-step centrifugation method. Patients were instructed to instill these drops six times daily for 4 weeks. The Canadian Dry Eye Assessment (CDEA) questionnaire score, patient subjective assessment (PSA) score, first and average non-invasive break-up times (f/a NIBUT), tear meniscus height (TMH), bulbar redness (BR), and meibograph grade (MG) were measured before and after the treatment course.
Significant improvements in dry eye symptoms and tear film parameters were observed. Dry eye symptoms significantly improved as per the CDEA (mean difference (MD) = -5.45, 95% confidence interval (CI) = [-7.9, -3.1], <0.001) and PSA (MD = -2.6, 95% CI = [-3.9, -1.2], <0.001). There were significant improvements in tear film parameters including fNIBUT (MD = 3.85s, 95% CI = [1.2, 6.8], =0.006), aNIBUT (MD = -6.81s, 95% CI = [5.7, 11.1], <0.001) and TMH (MD = 0.08, 95% CI = [0.003, 0.2], =0.045). There was an improvement in conjunctival injection as measured by BR (MD = -0.36, 95% CI = [-0.4, -0.15], =0.373). Five eyes experienced a one-grade improvement in MG (=0.453), and none experienced worsening in MG with treatment. No temporary or permanent adverse effects were noted.
Four weeks of PRP therapy resulted in significant functional improvements in dry eye symptoms and tear film quality and quantity. Improvements in conjunctival injection and microstructural improvements in meibomian glands were also observed in some eyes. Overall, PRP is a promising treatment option for patients with EDE from MGD refractory to conventional treatments.
评估自体富血小板血浆（PRP）滴眼液对睑板腺功能障碍（MGD）所致蒸发型干眼（EDE）疾病的疗效。
这是一项回顾性、连续性病例系列研究，于2020年11月至2021年11月在加拿大安大略省的一家门诊诊所，对10例MGD所致EDE患者的20只眼睛进行了PRP滴眼液治疗。PRP滴眼液采用两步离心法从全血中制备。指导患者每天滴注这些滴眼液6次，持续4周。在治疗过程前后测量加拿大干眼评估（CDEA）问卷评分、患者主观评估（PSA）评分、首次和平均非侵入性泪膜破裂时间（f/a NIBUT）、泪河高度（TMH）、球结膜充血（BR）和睑板腺图像分级（MG）。
观察到干眼症状和泪膜参数有显著改善。根据CDEA（平均差值（MD）=-5.45，95%置信区间（CI）=[-7.9，-3.1]，<0.001）和PSA（MD=-2.6，95%CI=[-3.9，-1.2]，<0.001），干眼症状显著改善。泪膜参数有显著改善，包括fNIBUT（MD=3.85秒，95%CI=[1.2，6.8]，=0.006）、aNIBUT（MD=-6.81秒，95%CI=[5.7，11.1]，<0.001）和TMH（MD=0.08，95%CI=[0.003，0.2]，=0.045）。通过BR测量的结膜充血有所改善（MD=-0.36，95%CI=[-0.4，-0.15]，=0.373）。5只眼睛的MG改善了一级（=0.453），治疗后无一只眼睛的MG恶化。未观察到临时或永久性不良反应。
4周的PRP治疗使干眼症状以及泪膜的质量和数量在功能上有显著改善。在一些眼睛中还观察到结膜充血改善以及睑板腺微观结构改善。总体而言，对于传统治疗无效的MGD所致EDE患者，PRP是一种有前景的治疗选择。
