Platelet-rich plasma for treating dry eye disease - A systematic review and meta-analysis

Prince Kwaku Akowuah; Chukwuemeka Junior Obinwanne; Ebenezer Owusu; Sylvester Kyeremeh; Kwaku Bonsu; Lucy Akua Afriyie Karikari; Felicia Akyaa Akomeah; Ernest Kyei Nkansah; Emmanuel Kobia-Acquah

doi:10.1016/j.clae.2023.102091

Platelet-rich plasma for treating dry eye disease - A systematic review and meta-analysis

Cont Lens Anterior Eye. 2024 Feb;47(1):102091. doi: 10.1016/j.clae.2023.102091. Epub 2023 Nov 10.

Authors

Prince Kwaku Akowuah¹, Chukwuemeka Junior Obinwanne², Ebenezer Owusu³, Sylvester Kyeremeh⁴, Kwaku Bonsu⁵, Lucy Akua Afriyie Karikari⁶, Felicia Akyaa Akomeah⁴, Ernest Kyei Nkansah⁷, Emmanuel Kobia-Acquah⁸

Affiliations

¹ College of Optometry, University of Houston, Houston, TX, USA. Electronic address: pkakowua@central.uh.edu.
² Cornea and Contact Lens Unit, De Lens Ophthalmic Family and Vision Care Centre, Abuja, Nigeria.
³ College of Optometry, University of Houston, Houston, TX, USA. Electronic address: eowusu@uh.edu.
⁴ Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁵ College of Optometry, University of Houston, Houston, TX, USA. Electronic address: kbonsu@cougarnet.uh.edu.
⁶ First Vision Eye Care and Medical Devices, Kumasi, Ghana. Electronic address: lucyakuaafriyie1@gmail.com.
⁷ Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland.
⁸ Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; Centre for Eye Research Ireland, Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland. Electronic address: kobiaacquah@yahoo.com.

PMID: 37951738
DOI: 10.1016/j.clae.2023.102091

Abstract

Purpose: Dry eye disease has public health and economic significance. Platelet-rich plasma is rich in anti-inflammatory agents and growth factors, both beneficial for ocular surface repair. This study aimed to conduct a systematic review and meta-analysis to summarize the benefits of platelet-rich plasma for treating dry eye disease and its adverse effects.

Methods: Prospective comparative studies using platelet-rich plasma as monotherapy for dry eye disease were included for efficacy assessment. Before-after studies were included for adverse events assessment. Data sources included PubMed, Google Scholar, Web of Science, and Scopus. A systematic review and meta-analysis protocol was pre-registered on PROSPERO (CRD42022347982). PRISMA guidelines were followed. The National Health Institute (NIH) quality assessment tool for before-after studies, the Cochrane risk of bias tool (RoB2), and the methodological index for non-randomized studies were used to assess the risk of bias. Heterogeneity was assessed using the I² statistic.

Results: 19 studies (10 comparative and 9 before-after) were included in the systematic review and meta-analysis. The occurrence rate of adverse effects was 2.6 % (95 % CI: 0.5 - 4.7). The pooled standardized mean difference (SMD) for dry eye symptoms was 0.81 (95 % CI: 0.25 - 1.37; I² = 82 %; p < 0.00001; Z = 2.84, p = 0.004); tear quality was 0.44 (95 % CI: 0.06 - 0.81; I² = 67 %; p = 0.003; Z = 2.26, p = 0.02); tear quantity was 0.45 (95 % CI: 0.03 - 0.88; I² = 74 %; p = 0.0003; Z = 2.10, p = 0.04); and corneal staining 0.72 (95 % CI: 0.14 - 1.30; I² = 85 %; p < 0.00001; Z = 2.43, p = 0.02).

Conclusion: The current study shows that platelet-rich plasma is efficacious in managing dry eye disease, significantly reducing dry eye signs and symptoms. Such significant improvements could translate to improved quality of life.

Keywords: Dry eye disease; Platelet-rich plasma; Symptoms; Tear quality; Tear quantity.

Publication types

Comparative Study
Meta-Analysis
Systematic Review

MeSH terms

Dry Eye Syndromes* / metabolism
Dry Eye Syndromes* / therapy
Humans
Platelet-Rich Plasma* / metabolism
Prospective Studies
Quality of Life