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Using your own spun plasma to heal a corneal ulcer?


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Has anyone seen or heard of this being done in humans?  We had to take our dog into the ER vet last night for what I thought was conjunctivitis but turned out to be a good sized corneal ulcer.  Mainly because he's a dummy and keeps smashing his face into the carpet because it feels good I guess.  Anyway, other then the topical antibiotic, they drew his blood and spun his plasma up and gave us a vial to put in his eye 3x a day for two weeks.  I went home and looked it up and sure enough it is the standard of care for dogs.  It just got me thinking, has this been done in humans?  Seems easy enough as just about every office has a spinner.

Thanks 😄

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I worked in vet clinics for several years before going to PA school.  We had a dog with a delayed healing ulcer and that is exactly what we did.  Only recall the one dog getting this treatment.  This was 15+ years ago though.  Maybe it is used more now.  

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That's exactly what the vet told me.  She was young, cool and really seemed to know her stuff.  I was just wondering, why wouldn't this work in humans?  From the little research I have done, it is now the standard of care for corneal ulcers in dogs.

Plus there was just something really cool about her handing me a vial and saying, "This is your dogs plasma, put 3 drops in his eye 3x/day"....wow.

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22 minutes ago, bluiz1997 said:

I mean it works for many indications in humans.  It has worked great for skin rejuvenation for me.  My husband has had some great success with PRP joint injections.  Your pup needs some safety googles.

Right?  We currently have him in the "Cone of Shame..." tm.      LOL

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My wife had the platelet rich plasma injections done by her podiatrist for some ligamentous injuries.  It was couple with prolonged immobilization and then orthodics.  She definitely got better.  I'm not sure if the PRP made a difference vs just the immobilization and proper supports.  Other podiatrists were not so positive of the benefit.  The research I did, including looking up a Cochrane review, did not indicate a benefit.  We had to pay out of pocket as insurance didn't cover it.  So, in my house we have 1 believer and 1 skeptic.

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20 hours ago, Cideous said:

Has anyone seen or heard of this being done in humans?  We had to take our dog into the ER vet last night for what I thought was conjunctivitis but turned out to be a good sized corneal ulcer.  Mainly because he's a dummy and keeps smashing his face into the carpet because it feels good I guess.  Anyway, other then the topical antibiotic, they drew his blood and spun his plasma up and gave us a vial to put in his eye 3x a day for two weeks.  I went home and looked it up and sure enough it is the standard of care for dogs.  It just got me thinking, has this been done in humans?  Seems easy enough as just about every office has a spinner.

Thanks 😄

My mother-in-law has Sjogren's and struggles with keratoconjunctivitis sicca (dry eye syndrome).  She had her corneas scraped off and then "her own blood" was used to heal and help.  That is all she knew and knows, but I would assume this is what it is.  This was performed in Florida, and is NOT FDA approved (read that as "ridiculously expensive out of pocket procedure").  But, it helped her significantly.  She is not cured, but significantly better.  She was essentially blind because she couldn't keep her eyes open and then her eyelids would stick together.  She still has blepharospasms that she gets botox injections for and still has dry eyes but nothing like what she had.  She also goes back to FL periodically for some followup treatments (no idea what they are) and he makes eye drops from her blood (again, what I would assume is some form of plasma rich drops).

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Here's a trial where they use it humans, although it is being used on patients with an uncommon type of corneal ulcer:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031214/

 

Abstract

Purpose

Platelet-rich plasma (PRP) is an autologous blood product without preservatives and rich in proteins and growth factors which make it possible for cells to differentiate, proliferate, and migrate, thus stimulating healing and regeneration of tissues. The aim of this study was to evaluate the efficiency of autologous platelet-rich plasma in the treatment of neurotrophic keratopathy.

Methods

The study group consists of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface, subjective symptoms, and changes in corneal thickness with the use of anterior segment optical coherent tomography (AS-OCT).

Results

BCVA before the treatment was 0.10 ± 0.14, and after the treatment it was –0.3 ± 0.27 (p=0.001). Improved visual acuity and less subjective symptoms were observed in all patients. Complete healing of the ulceration was observed in 20 patients (80%). Four patients (16%) experienced considerable improvement of their clinical condition (reduced size and depth of the ulceration and inflammatory state: smaller conjunctival injection and swelling, improved visual acuity, and less subjective symptoms). In one of the patients, an amniotic membrane was transplanted due to the lack of improvement of his local condition. In all patients, the progression of corneal thinning was stopped. An average corneal thickness in its thinnest point was 322.3 ± 125.8 µm before the treatment, and 404.5 ± 118.7 µm (p < 0.05) after the treatment. None of the patients reported general or local side effects of the treatment.

Conclusions

Autologous platelet-rich plasma is a blood-based product which seems efficient in the treatment of neurotrophic keratopathy.

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4 hours ago, cbrsmurf said:

Here's a trial where they use it humans, although it is being used on patients with an uncommon type of corneal ulcer:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6031214/

 

Abstract

Purpose

Platelet-rich plasma (PRP) is an autologous blood product without preservatives and rich in proteins and growth factors which make it possible for cells to differentiate, proliferate, and migrate, thus stimulating healing and regeneration of tissues. The aim of this study was to evaluate the efficiency of autologous platelet-rich plasma in the treatment of neurotrophic keratopathy.

Methods

The study group consists of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface, subjective symptoms, and changes in corneal thickness with the use of anterior segment optical coherent tomography (AS-OCT).

Results

BCVA before the treatment was 0.10 ± 0.14, and after the treatment it was –0.3 ± 0.27 (p=0.001). Improved visual acuity and less subjective symptoms were observed in all patients. Complete healing of the ulceration was observed in 20 patients (80%). Four patients (16%) experienced considerable improvement of their clinical condition (reduced size and depth of the ulceration and inflammatory state: smaller conjunctival injection and swelling, improved visual acuity, and less subjective symptoms). In one of the patients, an amniotic membrane was transplanted due to the lack of improvement of his local condition. In all patients, the progression of corneal thinning was stopped. An average corneal thickness in its thinnest point was 322.3 ± 125.8 µm before the treatment, and 404.5 ± 118.7 µm (p < 0.05) after the treatment. None of the patients reported general or local side effects of the treatment.

Conclusions

Autologous platelet-rich plasma is a blood-based product which seems efficient in the treatment of neurotrophic keratopathy.

Wow

Just fascinating.  It never ceases to amaze me that nature has already given us the tools to heal many of the things that ails us, we just have to learn where to look.

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5 years as an ophthalmology tech in a rural practice. I only saw PRP drops used once, for an Sjogren's patient with recurrent corneal erosion, refractory to everything else. It's much more common for cornea specialists to use it in resurfacing procedures, like mcgriffths mother-in-law. Amniotic membranes were (probably still are?) far more popular.

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On 5/5/2020 at 10:14 AM, Cideous said:

Has anyone seen or heard of this being done in humans?  We had to take our dog into the ER vet last night for what I thought was conjunctivitis but turned out to be a good sized corneal ulcer.  Mainly because he's a dummy and keeps smashing his face into the carpet because it feels good I guess.  Anyway, other then the topical antibiotic, they drew his blood and spun his plasma up and gave us a vial to put in his eye 3x a day for two weeks.  I went home and looked it up and sure enough it is the standard of care for dogs.  It just got me thinking, has this been done in humans?  Seems easy enough as just about every office has a spinner.

Thanks 😄

Yes they have been doing this in dentistry for a while now. Too bad the MDs and DOs pushed them out of "medicine" in the 1930s. WE could learn a lot from biological dentistry. PRF and PRP was used a lot. With a tooth extraction (after destruction of the periodontal ligament) they use low level laser to the area, do not use vasoconstrictiors (so you get blood to the area so one can heal), use ozone (liquid) in the socket and then put PRF/PRP in the socket then put on suture in to hold it tight x 5-7 days. I have several (yes several!) root canals extracted 6 months ago or so and healed up within 48 hrs. Amazing! No medications were taken. NONE! I even had some osteonecorsis on one root canal noted on CT Conebeam. See below: 

 

Spin technique for collecting (PRF / PRP)

  1. Draw blood from patient using vacutainer holder with an attached sterile blood collection needle.
  2. Collect blood using a red top 10ml vacutainer collection tube for PRF and orange top 10ml vacutainer blood collection tube for PRP.
  3. Spin blood for 12 minutes in centrifuge unit at 1150 rpm’s for PRF. Spin blood for 3 minutesin centrifuge unit at 700 rpm’s for PRP.
    PRF: Draw off the top layer of liquid plasma from the collection tube and discard. Using sterile college pliers, remove the middle fibrin clot from tube and place onto sterile 2×2 gauge. Use sterile box to produce fibrin plug or flat, fibrin membrane. PRF sample is now ready for placement into surgical site.
    PRP: Using a sterile 3ml syringe with a 21-gauge needle, draw off the top clear, yellow liquid which contains the concentrated platelets or the liquid growth factors that will be used in the surgical site or mixed with autogenous bone grafting material.

 

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