Subconjunctival versus Topical Platelet-rich Plasma for Dry Eye: Retrospective Study

Purpose: Dry eye disease (DED) is a prevalent condition impairing the quality of life, with conventional treatments often failing to address underlying inflammation in moderate-to-severe cases. Platelet-rich plasma (PRP), rich in growth factors, promotes ocular surface healing, but optimal delivery methods remain unclear. This study compares the efficacy and safety of subconjunctival PRP injections versus topical PRP eye drops for moderate-to-severe DED. Methodology: A retrospective cohort study analysed the electronic health records from a tertiary eye care centre in Lucknow, India (August 2019–February 2021). Patients aged 18–65 years with DED (Schirmer’s test <10 mm, tear break-up time [TBUT] <10 s, tear meniscus height [TMH] <0.5 mm and ocular surface disease index [OSDI] >23) were included, excluding those with Sjögren’s syndrome, ocular injuries or incomplete records. Of 42 patients (84 eyes), Group 1 (40 eyes) received two 0.5 ml subconjunctival PRP injections (day 0 and day 14) and Group 2 (44 eyes) used PRP eye drops four times daily for 30 days. PRP was prepared from venous blood, centrifuged and diluted to 20% with balanced salt solution. Outcomes (OSDI, Schirmer’s test, TBUT and TMH) were measured at baseline, 1, 2 and 3 months under the controlled conditions. Statistical analyses included t -tests, Mann–Whitney U -tests and repeated-measures analysis of variance (SPSS v26.0, P < 0.05). Results: Both groups showed significant improvements from baseline ( P < 0.001). Subconjunctival PRP yielded faster, more pronounced improvements in all outcomes at 1 month ( P < 0.01), with peak effects at 1–2 months, followed by a slight decline by 3 months. Topical PRP provided gradual and sustained benefits. No serious adverse events occurred; minor, self-limiting complications were reported. Conclusion: Subconjunctival PRP offers rapid relief, while topical PRP supports long-term management. A combined approach may optimise DED treatment. Future trials should refine dosing protocols.