Autologous Serum (AS) Versus Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP) contains a higher concentrated of growth factors which stimulate epithelial cells faster than Autologous Serum or whole blood and lead to faster healing. PRP is obtained via centrifugation from whole blood mixed with anticoagulant. Platelets are critically important in the wound-healing process. They translocate rapidly to the wound site and adhere to the damaged tissue, initiating a healing reaction which includes the release of a variety of cytokines and growth factors. Hartwig et al. reported a superior effect on cell growth in platelet releasates in PRP than in Autologous Serum owing to its high content of growth factors 

Platlets contain α-granules which liberate a very high concentration of:

-platelet-derived growth factors, 

-platelet factor IV, 

-transforming growth factor (TGF)-β 

-circulating stem cells 

Thus, PRP is known to harbor higher concentrations of growth factors and can promote effective wound healing and may be better than Autologous Serum in certain patients. 

PRP eye drops can be used to treat ocular surface diseases, such as:

-pain after LASIK (laser-assisted in situ keratomileusis)

-ocular surface diseases

-corneal ulcers

-severe dry eye

-ocular graft-versus-host disease, 

-persistent epithelial defects, 

-neurotropic keratopathy, 

- recurrent epithelial erosions: it reduces the risk of recurrent erosions 

-infectious keratitis

-persistent epithelial defects

Kim, et al. reported improved outcomes with PRP eye drops than Autologous Serum eye drops in patients with persistent epithelial defect after infectious keratitis, for instance (Reference 1).

Autologous Serum (AS)

Autologous Serum (AS) acts as a lubricant on the ocular surface and also supplies several essential substances for the recovery of damaged epithelium. 

It contains:

- vitamin A

- epidermal growth factor (EGF)

-fibronectin and a variety of cytokines  

-circulating stem cells 

These factors help with the proliferation, migration, and differentiation of the ocular surface epithelium cells which helps restore the eye surface to prevent pain or heal a patient from pain.

Autologous Serum eye drops have been used for years for the treatment of:

-ocular surface diseases, 

-corneal ulcers

-severe dry eye, 

-ocular graft-versus-host disease, 

-persistent epithelial defects, 

-neurotropic keratopathy, 

- recurrent epithelial erosions: it reduces the risk of recurrent erosions (Reference 2)

References:

1. Kim KM, Shin YT, Kim HK. Effect of autologous platelet-rich plasma on persistent corneal epithelial defect after infectious keratitis. Jpn J Ophthalmol. 2012;56:544–550.

2. Del Castillo JM, de la Casa JM, Sardina RC, et al. Treatment of recurrent corneal erosions using autologous serum. Cornea. 2002;21:781–783

3. Alio JL, Pastor S, Ruiz-Colecha J, et al. Treatment of ocular surface syndrome after LASIK with autologous platelet-rich plasma. J Refract Surg. 2007

4. Hartwig D, Harloff S, Liu L, et al. Epitheliotrophic capacity of a growth factor preparation produced from platelet concentrates on corneal epithelial cells: a potential agent for the treatment of ocular surface defects? Transfusion. 2004;44:1724–1731

5. Korean J Ophthalmol. 2016 Apr; 30(2): 101–107.

Autologous Platelet-rich Plasma Eye Drops in the Treatment of Recurrent Corneal Erosions

Jun Hun Lee,1 Myung Jun Kim,1 Sang Won Ha,2 and Hong Kyun Kim1