Autologous platelet-rich plasma may treat extreme ocular hypotension
ATHENS, Greece — Autologous platelet-rich plasma showed efficacy in treating extreme ocular hypotension in a series of patients presented here at the European Society of Cataract and Refractive Surgeons Winter Meeting.
“PRP is a blood-derived product that enhances wound healing and stimulates tissue regeneration thanks to multiple growth factors contained in the blood. It is easy to prepare. A blood sample is taken from the patient’s arm and is then placed in a centrifuge, which spins and separates the platelets from the rest of the blood components; 3 mL to 6 mL of PRP are then extracted with a syringe and are ready to be injected intracamerally,” Omneya Al-Rahman, MD, said.
The first case was a 55-year-old man with Axenfeld-Rieger syndrome and elevated IOP resistant to glaucoma medications. He was implanted with an Ex-Press glaucoma shunt (Alcon) with adjunctive mitomycin C. Due to anterior segment dysgenesis, scleral atrophy, overfiltration and leaking of the conjunctival bleb occurred, leading to severe hypotony.
“We injected 0.3 mL of autologous PRP in the attempt to close the filtering area of the sclera and some days later performed Nd:YAG laser to dissolve the PRP remnants in the periphery. Final IOP was 13 mm Hg,” Al-Rahman said.
The second case was a 75-year-old woman with traumatic corneal opacity leading to a blind and cosmetically deformed eye with a thin cornea. She underwent keratopigmentation, but microperforation and hypotony occurred during surgery. She was injected with PRP to close the corneal perforation internally, followed by a touch of laser 12 days later. Final IOP was 13 mm Hg.
The same treatment was used in a 7-year-old girl with juvenile rheumatoid arthritis, uveitis and cyclitic membrane formation.
“Hypotony occurred as a further complication of uveitis, dramatically down to 1 mm Hg for 2 months and refractory to all treatments. We injected PRP to block the angle, and IOP is now 12 mm Hg,” Al-Rahman said.
The last case was an 88-year-old woman with late damage to the angle tissue after CyPass (Alcon) implantation. PRP was used to block iridodialysis, and IOP increased to 16 mm Hg.
“Autologous PRP injection is safe, effective, natural, quick and noninvasive, with no side effects or complications, and it is always there in our own blood,” Al-Rahman said. – by Michela Cimberle
Al-Rahman O, et al. Extreme ocular hypotension treated with platelet rich plasma (E-PRP). Presented at: ESCRS Winter Meeting; Feb. 15-17, 2019; Athens, Greece.
Disclosure: Al-Rahman reports no relevant financial disclosures.