# Comparative Evaluation of Autologous Platelet-Rich Plasma and Artificial Tears for Treatment of Chronic Evaporative Dry Eye Patients: A Prospective Interventional Study

## TL;DR

This study compares autologous platelet-rich plasma (PRP) and artificial tears in treating chronic dry eye, finding PRP more effective in improving symptoms and tear film stability over six months.

## Contribution

The study provides empirical evidence that autologous PRP is more effective than artificial tears in treating chronic evaporative dry eye disease.

## Key findings

- PRP showed significantly better improvement in ocular surface disease index (OSDI) and corneal fluorescence staining (CFS) scores compared to artificial tears.
- PRP improved tear breakup time (TBUT) and best-corrected visual acuity (BCVA), unlike artificial tears.
- No significant adverse effects were observed with PRP treatment over six months.

## Abstract

Background: Dry eye is a multifactorial ocular surface disorder. While artificial tears and anti-inflammatory medications are standard treatment, blood derivatives such as platelet-rich plasma (PRP) offer regenerative benefits as well and are gaining popularity in ophthalmology. This study aimed at the comparative evaluation of the clinical outcomes of autologous PRP eye drop and artificial tear eye drop (AT) therapy in the treatment of chronic evaporative dry eye patients with moderate to severe symptoms.

Methods: 100 patients with chronic (≥ 6 months duration) evaporative moderate to severe dry eye disease (DED) in the 18 years to 45 years age group were included in this prospective interventional study. We randomized patients into two equal groups (n = 50 each). One group received autologous PRP eye drops and the other AT drops. The outcome measures evaluated were subjective symptoms (ocular surface disease index (OSDI) score), objective tear film parameters (Oxford corneal fluorescence staining (CFS) score, tear breakup time (TBUT), and Schirmer’s test (ST) score), and best-corrected visual acuity (BCVA) (converted to LogMAR, with improvement defined as a gain of ≥ 1 Snellen line). Within the group and between the group, comparisons were done at the end of 6 months using paired and unpaired student’s t-tests, respectively.

Results: At the end of 6 months, both the treatment groups (PRP and AT) showed significant improvement in OSDI and CFS scores, whereas TBUT and BCVA improved significantly only in the PRP group. No significant changes were observed in ST in either group. The post-treatment, between-the-groups analysis also favored PRP in all the parameters except ST. The PRP group showed significantly better improvements than the AT group in OSDI (MD, i.e., mean difference = -20.9, t = -5.12, P < 0.0001), CFS score (MD = -0.83, t = -5.08, P < 0.0001), TBUT (MD = 1.28, t = 3.08, P = 0.003), and BCVA (MD = -0.025, t = -2.15, P = 0.034). No significant difference was found in ST (P = 0.4). No significant adverse effect was noted throughout the study.

Conclusion: In chronic evaporative DED patients, autologous PRP showed significantly better clinical outcomes than AT and was found to be safe when given for a 6-month duration.