Platelet-rich plasma injections in the management of severe dry eye
Bibliographic record
Abstract
Dear Editor, we would like to share ideas on ‘Assessment of the efficacy of platelet-rich plasma injections in the management of severe dry eye’[1]. Elessawy et al. concluded that ‘The use of PRP injections is safe and effective, …… but it is not effective in improving Meibomian gland function[1]’. The results from this report repeatedly confirm another similar report by Avila et al.[2]. We agree that platelet-rich plasma injections might be useful. However, it is considered a more harm procedure comparing to standard management. As a plasma product, it might consider safe but we should still recognize for risk for unknown pathogen contamination[3]. Finally, an allergic reaction might occur[4]. A small study with few subjects might not detect an adverse event. Hence, there should be a good preparation for any possible problem when there are usages in a large number of patients. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. 1. Elessawy KB, Araissi AB, Nasr HE, Abdelbaky SH. Assessment of the efficacy of platelet-rich plasma injections in the management of severe dry eye J Egypt Ophthalmol Soc. 2021;114:63–68 2. Avila MY, Igua AM, Mora AM. Randomised, prospective clinical trial of platelet-rich plasma injection in the management of severe dry eye Br J Ophthalmol. 2018 doi: 10.1136/bjophthalmol-2018-312072. 3. Greco C, Mastronardi C, Pagotto F, Mack D, Ramirez-Arcos S. Assessment of biofilm-forming ability of coagulase-negative staphylococci isolated from contaminated platelet preparations in Canada Transfusion. 2008;48:969–977 4. Latalski M, Walczyk A, Fatyga M, Rutz E, Szponder T, Bielecki T, Danielewicz A. Allergic reaction to platelet-rich plasma (PRP): case report Medicine (Baltimore). 2019;98:e14702 Reply to the Editor Regarding your concern (However, it is considered a more harm procedure comparing to standard management. As a plasma product, it might consider safe but we should still recognize for risk for unknown pathogen contamination). Generally, the use of platelet-rich plasma (PRP) is considered safer and more practical than other cell-based therapies, as they are autologous. Because it is an autologous preparation, PRP is inherently safe and therefore free from risk of transmittable diseases such as HIV, hepatitis, West Nile fever, and Cruetzfeldt-Jacob disease (CJD).[1] The procedure of PRP extraction and injection were done under compete aseptic condition. PRP was injected immediately after preparation with no storage. PRP is similar in composition to the blood clot that is formed in every wound, and therefore could not support bacterial growth any more than any other blood clot.[1] PRP has a pH of 6.5 to 6.7 compared with a mature blood clot of 7.0 to 7.2. It has thus been suggested that PRP actually inhibits bacterial growth.[1] We suggest use of PRP injection in severe not mild case, which is not improving. Also, punctal plug is considered also an intervention We surely emphasize the importance of compete sterilization during preparation and injection with immediate injection of PRP after preparation without storage to avoid this minimal possibility. And regarding the other concern (Finally, an allergic reaction might occur). It was only one case report after intra-articular injection of PRP that completely resolved within 4 days. This is attributed to calcium citrate used in preparation. It should be put into consideration; however, there are many studies on large scale support the safety of PRP injection in different parts of body whether intra-articular or in the face with no adverse side effects[2,3,4]. 1. Fukawa T, Yamaguchi S, Akatsu Y, Yamamoto Y, Akagi R, Sasho T. Safety and Efficacy F of S Intra-articular S Injection S of S Platelet-Rich S Plasma S in S Patients S With S Ankle S Osteoarthritis Foot Ankle Int. 2017;38(6):596–604 DOI doi: 10.1177/1071100717700377. Epub 2017 Apr 11. PMID:28399635 2. Kydd A.S.R., Hart D.A.. Efficacy and Safety of Platelet-Rich Plasma Injections for Osteoarthritis Curr Treat Options in Rheum. 2020;6:87–98 https://doi.org/10.1007/s40674-020-00142-1 3. Maisel-Campbell AL, Ismail A, Reynolds KA, Poon E, Serrano L, Grushchak S, Farid C, West DP, Alam M. A systematic review of the safety and effectiveness F of S platelet-rich S plasma F (PRP) S for S skin S aging Arch Dermatol Res. 2020;312(5):301–315 DOI doi: 10.1007/s00403-019- 01999-6. Epub 2019 Oct 18. PMID:31628542 4. Jaehoon Choi, Kyung Won Minn, Hak Chang. The Efficacy and Safety of Platelet-Rich Plasma and Adipose-Derived Stem Cells: An Update Arch Plast Surg. 2012;39(6):585–592 Published online 2012 Nov 14. doi: 10.5999/aps.2012.39.6.585 PMCID: PMC3518000
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.022 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.006 | 0.010 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".