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Randomised, prospective clinical trial of platelet-rich plasma injection in the management of severe dry eye
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  • Pedro-Ivan Navarro, Fernando Sierra Arango and Jose Bareño
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    Letter to Editor
    • Pedro-Ivan Navarro, Ophthalmologist - Cornea and External Diseases / Master of Science in Epidemiology Asociación Médica de Los Andes
    • Other Contributors:
      • Fernando Sierra Arango, Gastroenterologist - Master of Science in Epidemiology
      • Jose Bareño, Physician, Statistician, Master of Science in Epidemiology

    We have read the paper written by Avila MY et al “Randomised prospective clinical trial of platelet-rich plasma injection in the management of severe dry eye” . Authors have evaluated the effectiveness of platelet-rich injection in lacrimal gland plus free-demand topical lubricants drops in Sjögren’s syndrome severe dry eye patients . Diagnosis was based on Schirmer I, break-up time(BUT), ocular surface staining (Oxford grid) and OSDI . Achieved results in interventional group showed a Schirmer I (6,7+/-0,9 vs 9,2+/-1 mm, p<0,002), BUT (6,4+/-0,4 vs 4,4+/-0,3 secs p=0,0005), staining (2,15+/-0,15 vs 1,2+/-0,18 p<0,001) and OSDI (59+/-0,4 VS 34+/-4, p<0,001). Surprisingly authors have not included the lacrimal osmolarity test, the most valuable diagnostic tool to rule in/out this disease (S and Sp >90%) . Unfortunately Schirmer I (without anesthesia) evaluates not just basal lacrimal tearing, it also measures reflex response giving confounding bias in measured result. Surface staining (a qualitative variable) was mistakenly analyzed with a t-paired student test. Regarding OSDI, PRP patients showed a test improvement (pre 59+/- 4,0 vs post 34+/-4,0) without change in disease severity. Finally, this trial enrolled a low number of patients (n=15) that according to authors assumptions we would expect a much greater sample size (Epidat 4.1 n=417 eyes). In conclusion, a novel and interesting new treatment for Sjögren’s dry eye patients that must be confirmed in the f...

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    Conflict of Interest:
    None declared.