Background Plasma rich in growth factors (PRGF-Endoret) technology is an autologous platelet enriched plasma obtained from patient’s own blood, that allows the release of a pool of biologically active proteins that influence and promote a range of biological processes involved in tissue regeneration, including cell recruitment, growth and differentiation. In the past few years, PRGF-Endoret has been successfully used as an eye drop for the treatment of a wide range of ocular surface diseases, including dry eye, persistent corneal epithelial defects and ulcers. In ocular surgery, the amniotic membrane has been used with regenerative purposes for many years. But it has some disadvantages, including its allogeneic origin and high cost. Having an autologous membrane, obtained from the patient´s blood, would be a breakthrough in availability, patient safety and cost efficiency.
Purpose To develop and characterise a PRGF-Endoret fibrin membrane suitable for surgical application in ophthalmology.
Material and methods Blood was collected from healthy donors into 9 mL tubes containing anticoagulant. Blood was centrifuged; plasma column was drawn off avoiding the buffy coat, activated with CaCl2 and incubated at 37°C until membrane coagulation. Once the gel was formed, membranes were flattened using a 100 μm former. The mechanical tensile strength of 5 PRGF-Endoret membranes was evaluated using Instron5848. The ultrastructure was observed under scanning electron microscopy (SEM). The membranes obtained were applied in 17 patients for the treatment of different ocular surface pathologies.
Results The PRGF membranes obtained were manageable, the maximum load that could be withstood was 0.1±0.03N, the maximum deformation 1.1±0.38 and Young’s modulus was 0.085±0.055. SEM images showed that the membrane had a complex three-dimensional fibrillar structure. All the surgeries were successfully performed for the treatment of neurotropic keratitis, persistent epithelial defects and corneal ulcers, and all patient outcomes were satisfactory.
Conclusion It was possible to obtain a PRGF-Endoret membrane in ophthalmic surgery from the patient´s own blood. The PRGF-Endoret membrane had adequate mechanical characteristics and manageability for its surgical use in the treatment of ocular surface pathologies.
References and/or acknowledgements Riestra AC, Alonso-Herreros JM, Merayo-Lloves J. Platelet rich plasma in ocular surface. Arch Soc Esp Oftalmol2016;91:475–90.
Conflict of interest:
Corporate sponsored research or other substantive relationships: EA is the scientific director of BTI, and GO and FM are scientists at BTI.
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