Authors:Zhou Yanrong, Zhao Wenxin, Zhang Ming, Dang Yufei, Li Li
Corresponding author: Li Li, Email:eyelili@126.com
Published:2026-10-10
DOI: 10.3760/cma.j.cn115989-20260310-00111
ABSTRACT
Objective To compare the efficacy of platelet-rich plasma (PRP) versus 20% autologous serum (AS) in treating refractory corneal epithelial defects (RCED).
Methods A cohort study was conducted. A total of 50 consecutive patients (50 eyes) with RCED who were treated at the First Affiliated Hospital of Xi’an Jiaotong University from December 2022 to May 2025 were enrolled. Patients were assigned to the PRP group (12 patients, 12 eyes) or the AS group (38 patients, 38 eyes) according to their treatment. Corneal epithelial defect area was quantified using ImageJ software at baseline and at 4 and 8 weeks after treatment. Visual acuity was measured at baseline and 8 weeks after treatment. Corneal epithelial healing and visual acuity improvement were compared between the two groups. This study complied with the Declaration of Helsinki, and the study protocol was approved by the Ethics Review Committee of the First Affiliated Hospital of Xi’an Jiaotong University (No. XJTU1AF2025SY-376), and all patients provided written informed consent.
Results At 4 weeks after treatment, the mean corneal epithelial healing rate in the PRP group was (0.90±0.76)mm2/day, significantly faster than (0.51±0.24)mm2/day in the AS group (t=2.69,P<0.01). The healed area in the PRP group was greater than that in the AS group at both 4 and 8 weeks after treatment (both P<0.05). At 8 weeks after treatment, the visual acuity improvement in the PRP group and AS group was 0.05(-0.18, 0.33) and 0.00(-0.10, 0.49), respectively, with no statistically significant difference (U=216.50, P=0.802). The distribution of visual acuity improvement grades also showed no significant difference between the two groups (Z=0.18, P=0.864). After propensity score matching (8 matched pairs, all standardized mean differences <0.20), the healed corneal epithelial area in the PRP group at 4 weeks was (22.79±15.37)mm2, larger than (13.64±6.31)mm2 in the AS group (t=2.31,P<0.01).
Conclusions Both PRP and AS promote corneal epithelial healing. PRP exhibits a marked therapeutic advantage over AS and may be considered a preferential option for the management of RCED.
KEYWORDS：
Platelet-rich plasma;Autologous serum;Refractory corneal epithelial defect
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Authors Info & Affiliations
Zhou Yanrong
Department of Ophthalmology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, China
Zhao Wenxin
Department of Ophthalmology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, China
Zhang Ming
Department of Ophthalmology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, China
Dang Yufei
Department of Ophthalmology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, China
Li Li
Department of Ophthalmology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, China
Figures & Tables
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Figure 1 Comparison of corneal epithelial defect area between PRP and AS groups before and after treatment PRP: platelet-rich plasma; AS: autologous serum
Figure 2 Corneal images before and after treatment in two groups A: Before AS treatment B: After AS treatment C: Corneal fluorescein staining before AS treatment D: Corneal fluorescein staining after AS treatment E: Before PRP treatment F: After PRP treatment G: Corneal fluorescein staining before PRP treatment H: Corneal fluorescein staining after PRP treatment AS: autologous serum; PRP: platelet-rich plasma
Figure 3 Comparison of visual improvement between PRP group and AS group at 8 weeks after treatment A: Comparison of visual acuity changes between the two groups before and after treatment B: Proportion of patients with different levels of visual acuity improvement in the two groups PRP: platelet-rich plasma; AS: autologous serum; logMAR: logarithm of the minimum angle of resolution
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