Effect of Platelet-Rich Plasma in Nerve Regeneration After LASIK
ABSTRACT To investigate the effect of topical eye application of platelet-rich plasma (E-PRP) on the recovery of corneal sensitivity after LASIK and the anatomical recovery of the sub-basal corneal plexus as studied by confocal microscopy.
This was a randomized, consecutive, controlled, prospective and masked study on 108 myopic eyes receiving LASIK. The main variables of the study were the increase in corneal sensitivity (Cochet-Bonet aesthesiometer; Luneau, Paris, France) and the aspect of the sub-basal nerve plexus (confocal microscope). Additionally, a biomicroscopic study of the epithelial status of the cornea and a subjective questionnaire were completed. Each eye of each patient was assigned to one of two groups: 54 eyes treated with balanced saline solution and 54 fellow eyes receiving PRP drops for 3 months.
No significant differences were detected when the corneal sensitivity thresholds were compared at any postoperative visit in both groups (P > .05 for all comparisons). Almost identical sub-basal fiber densities were estimated for both groups before LASIK (t test, P = .66). However, the type and severity of staining detected during the slit-lamp examinations at the first and third month postoperatively were significantly less evident in the E-PRP treatment group (Wilcoxon test, P < .05).
PRP drops have beneficial effects for promoting epithelial status after LASIK but have no positive effect on recovery of corneal sensitivity, probably due to the limited bioavailability of growth factors in corneal stroma when the substance is topically administered.
- SourceAvailable from: Javier Tomás-Juan[Show abstract] [Hide abstract]
ABSTRACT: Dry eye disease is a troublesome ocular condition due to its multifactorial nature and the lack of association between signs and symptoms. This fact has led researchers to look beyond tear quality and stability, and hyperosmolarity and inflammation have lately been the focus of interest. Both are considered to have an impact on corneal nerve structure and function, although their role is still unclear. In this review, we will explore the peripheral and central nervous system mechanisms that contribute to the perception of dry eye symptoms and the possible changes in corneal pain pathways after long-standing tear deficiency and LASIK surgery that could result in corneal sensitivity or enhanced pain perception.
- Edited by Deniz Ekinci, 04/2015: chapter 1; , ISBN: 978-953-51-2040-7
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ABSTRACT: Dry eye is the most common post-operative complication in patients who undergo laser-assisted in situ keratomileusis and other photorefractive procedures. Epidemiological studies have found that almost all patients experience some form of dry-eye-related discomfort in the post-operative period. This review seeks primarily to identify patient factors, which predispose to this complication, as well as outline the possible interventions clinicians can consider to avoid, prevent and treat this complication. Numerous pre-, intra- and post-operative guidelines are provided. The ideal method of post-laser-assisted in situ keratomileusis dry eye prevention is a meticulous peri-operative management plan, as opposed to post-operative management alone. Newer modalities of photorefractive surgery may have differing effects on the ocular surface.Expert Review of Ophthalmology 01/2014; 8(6). DOI:10.1586/17469899.2013.851602