PRP Injection in to the Lacrimal Gland

Platelet rich plasma (PRP) is being used in all fields of medicine for cellular restoration. It has been used successfully in the following areas: 1. Skin rejuvenation 2. Hair loss restoration 3. Reconstruction of bone and tendons, for the management of 4. Tennis elbow tendinopathy repair: I have 3 patients who avoided surgery by having PRP injections 5. Corneal ulcers, 6. Chemical burns of cornea 7. post op LASIK pain 8. Dry eye: topical drops. In many patients the lacrimal gland is not functioning properly or likely replaced by scar tissue. Patients with Sjogren's syndrome have abnormal lacrimal gland function. I suspect people who have take Isotrentinoin acid (ie, Accutane) also have abnormal lacrimal gland function. The study below shows the benefit of PRP injection into the lacrimal gland. While it is still experimental, it might help many patients by re-creating cellular structure in the lacrimal gland. Though the below is a small study, it points to hope for future research in the devastating condition of dry eye disease. We hope to begin offering this procedure to help patients. The key issue is the cost as there are no guarantees of success with any of these experimental procedures and insurance does not cover them. Hopefully in the near future, we will have the ability to offer this via grant funds. Sandra Lora Cremers, MD, FACS

Marcel Y. Avila

Cornea. 33(1):18–21, JAN 2014

DOI: 10.1097/ICO.0000000000000016

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PMID: 24240491

Issn Print: 0277-3740

Publication Date: 2014/01/01

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Restoration of Human Lacrimal Function Following Platelet-Rich Plasma Injection

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Abstract

Purpose:

The aim was to evaluate the effect of autologous platelet-rich plasma on lacrimal function in patients with severe dry eye.

Methods:

A prospective interventional case series design was adopted. Four patients with severe lacrimal dysfunction and severe dry eye were treated. Platelet rich–activated plasma (1 mL) was injected adjacent to the lacrimal gland on day 0 and at 4, 8, and 12 weeks. The objective parameters included a Schirmer test, ocular surface staining, and tear break-up time (TBUT). The patients were followed up for 12 weeks after the first injection.

Results:

All cases showed a significant improvement in lacrimal volume (from 3.3 ± 0.8 mm to 11.1 ± 2.3 mm). In all the patients, an increase in tear break-up time values and a decrease in ocular staining (basal 8.0 ± 0.61–2.8 ± 0.5) with subjective improvement occurred. None of the patients presented any adverse effect, and none reported pain or discomfort. Additionally, no complications were observed.

Conclusions:

Injected platelet-enriched plasma was found to be safe and effective in increasing lacrimal production and in improving ocular staining secondary to severe dry eye. This approach could be an alternative for the management of these patients, although additional studies are required to perfect the technique.