PRP Injection into the Lacrimal Gland for Sjögren's Dry Eye: What the Evidence Shows

This post is for educational purposes and is not medical advice.

Severe dry eye is one of the most debilitating features of Sjögren's syndrome. When artificial tears, anti-inflammatory drops, and punctal plugs are not enough, a regenerative option is drawing attention: platelet-rich plasma (PRP). This post reviews what PRP is, how it is injected near the lacrimal gland, and what the published studies actually report.

What is PRP?

PRP is made from a small sample of the patient's own blood. The blood is spun in a centrifuge to concentrate platelets in plasma. Platelets release growth factors—such as EGF, PDGF, VEGF, NGF, and TGF-β—that support healing and regeneration of the ocular surface and, potentially, the tear-producing lacrimal gland.[5][6] Because it is autologous (from the patient's own body), the risk of allergic or immune reaction is low.[7]

Why the lacrimal gland?

In Sjögren's, immune cells attack the lacrimal gland, reducing tear production. The idea behind injecting PRP near the gland is to deliver regenerative growth factors directly to the damaged tissue, aiming to restore tear output rather than just lubricating the surface.[1]

What the studies show

- In an early case series, patients with severe lacrimal dysfunction who received 1 mL of activated PRP injected next to the lacrimal gland on day 0 and at weeks 4, 8, and 12 showed a striking rise in tear production (Schirmer test from about 3.3 mm to 11.1 mm), longer tear film stability, and less surface damage—with no reported pain or complications.[1]

- A randomized clinical trial in Sjögren's patients compared PRP injection (days 0, 30, 60, 90) plus hyaluronic acid drops against hyaluronic acid drops alone. The PRP group had significantly better corneal staining, Schirmer scores (5.6 → 9.0 mm), and tear break-up time (4.0 → 6.4 seconds).[2]

- A 2025 study of subconjunctival PRP injections (five injections over the year) reported sustained improvement in refractory dry eye out to 12 months, with no serious adverse events.[3]

- PRP given as eye drops has also been shown to improve dry eye symptoms and signs in Sjögren's patients, performing at least as well as autologous serum drops and being faster to prepare.[4][5][6]

A typical injection protocol (as reported in the literature)

1. Baseline assessment: symptom score (OSDI), Schirmer test, tear break-up time, and corneal/conjunctival staining.[2][1]

2. Blood draw and PRP preparation: the patient's blood is collected and centrifuged; the PRP is then activated for injection.[1]

3. Injection: about 1 mL of PRP is injected adjacent to the lacrimal gland in the upper-outer part of the eye socket.[1]

4. Schedule: repeated at weeks 4, 8, and 12 (four sessions total).[2][1]

5. Follow-up: re-evaluation at 30, 60, and 90 days.[2]

Important cautions

- This is an off-label, still-investigational treatment. It is not a standard, FDA-approved therapy for dry eye.[2][8]

- It should be performed only by an eye specialist experienced in periorbital injections, because of the delicate anatomy around the lacrimal gland and eye.

- Published safety data are reassuring but come from small studies; larger, longer trials are needed.[2][1][3]

- PRP does not replace overall Sjögren's management and should be discussed within a full treatment plan.

Bottom line

For people with severe Sjögren's dry eye that does not respond to conventional treatment, PRP—whether as lacrimal-gland injection, subconjunctival injection, or eye drops—is an emerging, generally well-tolerated option with encouraging early results. Anyone considering it should talk with an ophthalmologist about whether it fits their situation.

This post is for educational purposes and is not medical advice.

The protocol and post are grounded in the strongest available sources: Avila's lacrimal-adjacent injection technique (1 mL, days 0/4/8/12 weeks), the randomized injection trial confirming benefit over hyaluronic acid, the newer subconjunctival long-term data, and the drop-based Sjögren's studies.[1][2][3][4][5][6] Note that the evidence base is small (case series and modest randomized trials), the technique is off-label, and no professional society has issued a formal guideline endorsing lacrimal-gland PRP injection—so it is important to counsel patients this is still in an investigational status.[2][8]

References

1. Restoration of Human Lacrimal Function Following Platelet-Rich Plasma Injection. Avila MY. Cornea. 2014;33(1):18-21. doi:10.1097/ICO.0000000000000016.
2. Randomised, Prospective Clinical Trial of Platelet-Rich Plasma Injection in the Management of Severe Dry Eye. Avila MY, Igua AM, Mora AM. The British Journal of Ophthalmology. 2018;:bjophthalmol-2018-312072. doi:10.1136/bjophthalmol-2018-312072.
3. Sustained Long-Term Benefits of Autologous Subconjunctival Platelet-Rich Plasma Injections for Severe Dry Eye Disease. Mora AM, Córdoba CM, Jimenez-Mora MA, Padilla-Pantoja FD. Regenerative Medicine. 2025;20(8):331-338. doi:10.1080/17460751.2025.2544486.
4. Efficacy and Safety of Platelet-Rich Plasma and Autologous-Serum Eye Drops for Dry Eye in Primary Sjögren's Syndrome: A Randomized Trial. Kang MJ, Lee JH, Hwang J, Chung SH. Scientific Reports. 2023;13(1):19279. doi:10.1038/s41598-023-46671-2.
5. The Comparison Between the Composition of 100% Autologous Serum and 100% Platelet-Rich Plasma Eye Drops and Their Impact on the Treatment Effectiveness of Dry Eye Disease in Primary Sjogren Syndrome. Wróbel-Dudzińska D, Przekora A, Kazimierczak P, et al. Journal of Clinical Medicine. 2023;12(9):3126. doi:10.3390/jcm12093126.
6. Comparison of Epitheliotrophic Factors in Platelet-Rich Plasma Versus Autologous Serum and Their Treatment Efficacy in Dry Eye Disease. Metheetrairut C, Ngowyutagon P, Tunganuntarat A, et al. Scientific Reports. 2022;12(1):8906. doi:10.1038/s41598-022-12879-x.
7. The Effect of Immunologically Safe Plasma Rich in Growth Factor Eye Drops in Patients With Sjögren Syndrome. Sanchez-Avila RM, Merayo-Lloves J, Riestra AC, et al. Journal of Ocular Pharmacology and Therapeutics : The Official Journal of the Association for Ocular Pharmacology and Therapeutics. 2017;33(5):391-399. doi:10.1089/jop.2016.0166.
8. Dry Eye Disease. Hakim FE, Farooq AV. JAMA. 2022;327(5):478-479. doi:10.1001/jama.2021.19963