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Use of autologous plasma rich in growth factors fibrin membrane in the surgical management of ocular surface diseases

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Abstract

Purpose

To evaluate the safety and efficacy of the surgical use of autologous plasma rich in growth factors fibrin membrane (mPRGF) in improving corneal wound healing and regeneration in a variety of complex ocular surface defects.

Methods

Chart review on 15 eyes of 14 included patients undergoing ocular surface intervention using intraoperative mPRGF at the Bascom Palmer Eye Institute and at the Instituto Oftalmológico Fernández-Vega was performed. Patients were grouped based on type of intervention or condition (penetrating keratoplasty, superficial keratectomy, neurotrophic or persistent corneal ulcers, and corneal perforation). Patients were followed for an average of 11 ± 5 months. Main outcomes measured were mPRGF dissolving time, best-corrected visual acuity, and evidence of any persistent epithelial defects, rejections, or complications.

Results

All 15 eyes underwent successful placement of mPRGF. Average dissolving time for fibrin membrane was 21 ± 3 days. mPRGF resulted in total healing of the corneal defects in 13/15 (86.7%) of the treated eyes and partial healing in 2/15 (13.3%) eyes in which persistent epithelial defects were noted on follow-up. Visual acuity improvement was seen in 9/15 (60%) of the cases.

Conclusion

The use of autologous mPRGF in the healing and regeneration of the ocular surface is a secure and efficacious surgical option. Our data demonstrate that PRGF fibrin membrane should be contemplated as an important tool to optimize ocular surface regeneration in complex cases.

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Data availability

The data that support the findings of this study are available on request from the corresponding author, VLP.

Abbreviations

mPRGF:

Plasma rich in growth factor fibrin membrane

PRGF:

Plasma rich in growth factor

AMT:

Amniotic membrane transplant

LSCD:

Limbal stem cell deficiency

AS:

Autologous serum

BCVA:

Best-corrected visual acuity

PED:

Persistent epithelial defect

PK:

Penetrating keratoplasty

SK:

Superficial keratectomy

WP:

Whole plasma

LP:

Light perception

HM:

Hand motion

CF:

Count fingers

HSV:

Herpes simplex virus

DALK:

Deep anterior lamellar keratoplasty

PRK:

Photorefractive keratectomy

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Acknowledgements

V.L.P.: National Institutes of Health/National Eye Institute R01EY030283, R41EY029185-01, R01EY024485, Alcon, Dompe, Kala, Novartis, Quidel, EyeGate Pharm

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Bascom Palmer Eye Institute, Ocular Surface Center, University of Miami Miller School of Medicine, Miami, USA

    Alfonso L. Sabater, Xavier Quinones, Felipe Valenzuela & Victor L. Perez

  2. Steven and Frances Foster Distinguished Chair in Ocular Immunology, Duke Eye Center for Ocular Immunology, Duke University School of Medicine, Durham, NC, 27705, USA

    Hazem M. Mousa & Victor L. Perez

  3. Fernández-Vega University Institute, Ophthalmologic Research Foundation, University of Oviedo, Oviedo, Spain

    Ronald Mauricio Sanchez Avila & Jesús Merayo

  4. Foundation Eduardo Anitua, Victoria, Spain

    Gorka Orive & Eduardo Anitua

  5. Biotechnology Institute (BTI), Victoria, Spain

    Gorka Orive & Eduardo Anitua

  6. NanoBioCel Group, Laboratory of Pharmaceutics, School of Pharmacy, University of the Basque Country UPV/EHU, Paseo de la Universidad 7, 01006, Vitoria-Gasteiz, Spain

    Gorka Orive

  7. Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Vitoria-Gasteiz, Spain

    Gorka Orive

Authors
  1. Alfonso L. Sabater
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  2. Hazem M. Mousa
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  3. Xavier Quinones
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  4. Felipe Valenzuela
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  5. Ronald Mauricio Sanchez Avila
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  6. Gorka Orive
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  7. Eduardo Anitua
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  8. Jesús Merayo
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  9. Victor L. Perez
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Contributions

ALS, VLP, RMSA, JM contributed to study conception and design. ALS, VLP, JM, GO, EA contributed to resources/material. ALS, VLP, RMSA, JM contributed to acquisition of data. ALS, VLP, RMSA, JM, XQ, FV, HMM contributed to analysis and interpretation of data. ALS, VLP, RMSA, HMM contributed to drafting of manuscript. ALS, VLP contributed to critical revision and final approval.

Corresponding author

Correspondence to Victor L. Perez.

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Conflict of interest

Eduardo Anitua is the Scientific Director of BTI Biotechnology Institute. Gorka Orive is a scientist at BTI Biotechnology Institute, a dental company that investigates PRGF-Endoret technology and oral implantology. The rest of the authors declare that there is no conflict of interest regarding the publication of this paper.

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Informed consent for participation was obtained from all participants included in the study.

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Sabater, A.L., Mousa, H.M., Quinones, X. et al. Use of autologous plasma rich in growth factors fibrin membrane in the surgical management of ocular surface diseases. Int Ophthalmol 41, 2347–2358 (2021). https://doi.org/10.1007/s10792-021-01788-z

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  • DOI: https://doi.org/10.1007/s10792-021-01788-z

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