Background:
Aqueous-deficient dry eye (ADDE) is characterised by reduced tear production, leading to pain, discomfort, decreased quality of life, and potential visual impairment. Biological tear substitutes are recommended for patients who have had an inadequate response to first-line treatments, offering biological advantages over artificial tears. Autologous serum (AS) eye drops are the most widely used blood-derived product for treating ADDE. However, emerging evidence suggests that platelet-based products, such as Platelet-Rich Plasma (PRP), may offer superior healing effects compared to AS.
Aims and Hypotheses:
While recent trials and observational studies have compared PRP and AS, their relative efficacy and safety remain inconclusive, with no comprehensive systematic review or meta-analysis on this topic. We aim to address this need by systematically evaluating and comparing the effectiveness and safety of these treatments. Our primary objective is to assess improvements in Ocular Surface Staining (OSS), Tear Break-Up Time (TBUT), Schirmer’s I test, best corrected visual acuity (BCVA) and Ocular Surface Index (OSDI) scores. We will evaluate the adverse effects of each treatment. We hypothesise that PRP, with its higher concentrations of growth factors and bioactive molecules, will demonstrate superior efficacy while maintaining a comparable safety profile to AS.
Methods:
A systematic review and meta-analysis will be conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Relevant studies will be sourced from PubMed, Embase, and Cochrane Library, with Covidence used for screening. Statistical analysis will include weighted mean differences for continuous outcomes and risk ratios for dichotomous outcomes, using Cochrane Review Manager (RevMan). Heterogeneity will be assessed using I² and Cochran’s Q test. Publication bias will be examined using funnel plots and Egger’s test.
Expected Outcomes:
This study will provide evidence-based insights into the comparative benefits of PRP and AS, enabling clinicians to make informed treatment decisions, optimising ADDE management.