Autologous platelet-rich plasma serum versus punctal plugs for treatment of moderate to severe dry eye disease

Background Dry eye disease (DED) is a common condition that affects tear production and quality. It is classified into aqueous-deficient dry eye and evaporative dry eye, each requiring different treatment approaches. Advanced therapies, including autologous platelet-rich plasma (PRP) eye drops and punctal plugs, are often necessary for managing moderate to severe cases. Objectives This study aimed to compare the efficacy of autologous PRP eye drops and inferior silicone punctual plugs in treating moderate to severe DED. Patients and methods A nonrandomized comparative study was conducted on 46 patients divided into two groups: group I (25), treated with PRP and group II (21), treated with silicone plugs, aged 44–74 years with bilateral moderate to severe DED. Baseline assessments included Ocular Surface Disease Index, Schirmer test, fluorescein break-up time, and corneal fluorescein staining. Follow-up evaluations occurred at 2 weeks, 1 month, and 3 months. Results Mean ages were 60.12±8.35 years (group I) and 61.95±9.4 years (group II). Ocular Surface Disease Index scores decreased substantially from baseline in both groups ( P <0.05), with no notable intergroup variations. Schirmer test values improved considerably ( P <0.05) without intergroup differences. Fluorescein break-up time and corneal fluorescein staining scores also showed significant improvements in both groups ( P <0.05). Plug loss was considerably higher in group II (47.62%, P <0.001). Conclusions Both treatments were effective in improving DED parameters, with PRP demonstrating fewer complications.