Efficacy of platelet-rich plasma lysate in patients with corneal erosion or post-traumatic scarring of the tissues of the eyelids
https://doi.org/10.21516/2072-0076-2020-13-3-8-14
Abstract
Purpose: to evaluate the effectiveness of platelet-rich plasma (PRP) lysate in patients with corneal erosion or posttraumatic scarring of eyelid tissues.
Material and methods. The study involved 30 patients aged 22 to 82 (51.5 ± 19.1 years): 10 with persistent corneal erosions, who were treated in 2 stages (2 weeks of standard keratoprotective therapy, then treatment supplemented with instillations of PRP lysate) and 20 patients with post-traumatic scarring of eyelid tissues, who were divided into a clinical group and a comparison group. PRP lysate was produced in the cell transplantation and immunotyping laboratory of N.V. Sklifosovsky Research Institute for Emergency Medicine.
Results. In group 1, already on the 3rd day of PRP lysate use, a positive dynamic of the cornea was observed: all patients had fewer complaints of pain, photophobia, and lacrimation. Corneal biomicroscopy, performed daily over the entire epithelization period, revealed a decrease in hyperemia of the tarsal and bulbar conjunctiva and corneal edema, which indicated a weakened inflammatory response. On average, the area of the cornea at the start of traditional therapy was 21.6 [19.6; 30.65] mm2. After two weeks of treatment, at the time of adding PRP lysate, the average area of erosion fell to 15.7 [12; 18.9] mm2, after a week of treatment with lysate, it dropped to an average of 2.35 [0.4; 4.3] mm2. On day 14, all patients revealed complete epithelialization of the corneal defect. In patients with post-traumatic eyelid tissue scars, after a 3-month-long use of PRP lysate (study group), an improvement was noted in the cosmetic and functional state of the eyelids, on average by 4 points (Me = 12 [10; 12] points before and 8.5 [8; 9] points after treatment (on the Manchester scar assessment scale), in contrast to the patients who received no anti-scar therapy (comparison group), as the latter showed a deterioration in the condition of eyelid scars by 1–2 points (Me = 11 [10.25; 11.75] points at the beginning and 12 [11; 12] points at the end of the observation period). The acoustic density of scar tissue in the study group approached the normal values, in contrast to the comparison group, in which scar tissue appeared to be hypoechoic.
Conclusion. Using PRP lysate aimed at improving the repair and regeneration processes in patients with corneal erosion or post-traumatic scarring of eyelid tissues is promising and requires further clinical study.
About the Authors
N. V. BorovkovaRussian Federation
Natalia V. Borovkova — Dr. of Med. Sci., head of the laboratory of cell transplantation and immunotyping.
3, Bolshaya Sukharevskaya Square, Moscow, 129090
I. A. Filatova
Russian Federation
Irina A. Filatova — Dr. of Med. Sci., head of the department of plastic surgery and eye prosthetics.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
E. V. Chentsova
Russian Federation
Ekaterina V. Chentsova — Dr. of Med. Sci., professor, head of the department of traumatology.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
E. V. Fedoseeva
Russian Federation
Elena V. Fedoseeva — ophthalmologist, department of traumatology.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
Yu. A. Pavlenko
Russian Federation
Yuri A. Pavlenko — PhD student, department of plastic surgery and eye prosthetics.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
I. N. Ponomarev
Russian Federation
Ivan N. Ponomarev — Cand. of Med. Sci., surgeon, researcher, laboratory of cell transplantation and immunotyping.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
S. A. Shemetov
Russian Federation
Sergey A. Shemetov — Cand. of Med. Sci., ophthalmic surgeon, department of plastic surgery and eye prosthetics.
14/19, Sadovaya-Chernogryazskaya St., Moscow, 105062
A. O. Petrova
Russian Federation
Alena O. Petrova — ophthalmic surgeon, junior researcher, department of traumatology.
3, Bolshaya Sukharevskaya Square, Moscow, 129090
References
1. Chentsova E.V., Fedoseeva E.V., Ponomarev I.N., Borovkova N.V. Method for treating corneal defects using an autologous thrombofibrin clot. Patent RF 2699206; 2019 (in Russian).
2. Filatova I.A., Kiseleva T.N., Iomdina E.N., et al. Echodensitometry in assessing the acoustic properties of eyelid tissues in normal and scar deformities. Point of view. EastWest. 2015; 1: 236–7 (in Russian).
3. Filatova I.A., Romanova I.A. the First experience of using the laser Doppler flowmetry method in assessing the state of scars at various terms. Vestnik OGU. 2010; 12: 234–6 (in Russian).
4. Fedoseeva E.V., Chentsova E.V., Borovkova N.V., Alekseeva I.B., Romanova I.Yu. Morphofunctional peculiarities of platelet rich plasma and its application in ophthalmology. Ophthalmology in Russia. 2018; 15 (4): 388–93 (in Russian). https://doi.org/10.18008/1816
5. Leo M.S., Kumar A.S., Kirit R., Konathan R., Sivamani R.K. Systematic review of the use of platelet-rich plasma in aesthetic dermatology. J. Cosmet. Dermatol. 2015 Dec; 14 (4): 315–23. https://doi.org/10.1111/jocd.12167
6. Makarov M.S., Kobzeva E.N., Vysochin I.V., Borovkova N.V., Khvatov V.B. Morphofunctional analysis of human platelets using vital staining. Bulletin of experimental biology and medicine. 2013; 156: 9: 388–91 (in Russian).
7. Nishida T., Nakamura M., Ofuji K., et al. Synergistic effects of substance P with insulin-like growth factor-1 on epithelial migration of the cornea. J. Cell Physiol. 1996 Oct; 169 (1): 159–66. doi: 10.1002/(SICI)1097-4652(199610)169:1<159:AID-JCP16>3.0.CO;2-8
8. Van Setten G.B., Viinikka L., Tervo T., et al. Epidermal growth factor is a constant component of normal human tear fluid. Graefes Arch. Clin. Exp. Ophthalmol. 1989; 227; 184–7. doi: 10.1007/BF02169794
9. Gupta A., Monroy D., Ji Z., et al. Transforming growth factor beta-1 and beta-2 in human tear fluid. Curr. Eye Res. 1996 Jun; 15 (6): 605–14. doi: 10.3109/02713689609008900
10. Fedoseeva E.V., Chentsova E.V., Borovkova N.V., et al. Case of autologous thrombofibrin clot application in a patient with post-burn persistent corneal erosion. Transplantologiya. The Russian journal of transplantation. 2019; 11 (2): 150–7 (in Russian). https://doi.org/10.23873/2074-0506-2019-11-2-150-157
11. Ponomarev I.N., Sakharova O.M., Makarov M.S., Malygina M.A., Borovkova N.V. Method of treatment of patients with shoulder neck fracture. Patent RF № 0002681753; 2019 (in Russian).
12. Fearmonti R., Bond J., Erdmann D., Levinson H. A review of scar scales and scar measuring devices. Eplasty. 2010; 10:e43. Published 2010 Jun 21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890387/
Review
For citations:
Borovkova N.V., Filatova I.A., Chentsova E.V., Fedoseeva E.V., Pavlenko Yu.A., Ponomarev I.N., Shemetov S.A., Petrova A.O. Efficacy of platelet-rich plasma lysate in patients with corneal erosion or post-traumatic scarring of the tissues of the eyelids. Russian Ophthalmological Journal. 2020;13(3):8-14. (In Russ.) https://doi.org/10.21516/2072-0076-2020-13-3-8-14