Mechanisms of the therapeutic effect of platelet-rich plasma in macular hole surgery

Abstract

Purpose: to describe the mechanisms of the therapeutic effect of platelet-rich plasma (PRP) components on the retina in macular hole (MH) surgery. Material and methods. The results of autologous PRP use in 36 cases of surgical treatment of eyes with idiopathic full-thickness MH sized 96 to 932 mm (ave. 546.4 ± 49.8 mm) are presented. Corrected visual acuity before surgery was 0.04 to 0.2 (0.09 ± 0.01). The quantity of cell elements in PRP fractions was determined using a hematological analyzer Sysmex XS-500i (Germany). Results: 2 months after the operation, all retinal layers in the MH area were found to restore in all patients, who showed an increase in visual acuity to 0.2–0.6 (0.40 ± 0.04). 35 patients (97 %) had no MH relapse over the 6-month post-surgery period. A technique was proposed to evaluate the quality of PRP by the presence of large platelets. The mechanisms of the therapeutic effect of PRP components on the retina were presented. Conclusion. The collection of data on the effectiveness of PRP components is instrumental in planning its wider use in the treatment of degenerative, infectious, post-traumatic and other disorders of eye structures. The evaluation of PRP quality by the content of functionally active platelets will also contribute to more effective PRP use in ophthalmology.

Keywords

• macular hole
• platelet-rich plasma