Dry Eye Clinic
Dr. Abdalrahman Alabsi
Platelet-Rich Plasma (PRP) Injections
By Dr. Abdalrahman Alabsi – Ophthalmologist | Last reviewed: October 2026
Platelet-rich plasma (PRP) injection into the lacrimal gland:
Platelet-rich plasma (PRP) injection into the lacrimal gland is currently classified as an experimental treatment that is practiced clinically as an off-label use, as it is not yet an approved indication for injection into the lacrimal gland.
It is used as a last-resort option or in advanced, complex cases (such as severe Sjögren's syndrome) that have not responded to the prescribed lines of treatment.
Scientific research on PRP injection into the lacrimal gland:
The strength of current evidence is rated low to moderate, as it relies on case series and small prospective and comparative studies (10 to 30 patients). Large, multicenter, double-blind studies that set unified standards for platelet concentration, technique, and dosage are still lacking.
Long-term effectiveness and durability of results
Follow-up in studies shows that improvements in tear secretion (Schirmer test) and tear film stability (TBUT) peak 3 to 6 months after completing the injection course (usually 3 to 4 sessions).
Waning effect and repetition: because the released growth factors act as a temporary regenerative stimulus, the effect usually begins to wane gradually after 6 months, often requiring ongoing booster sessions.
What patients should know before deciding on PRP injection into the lacrimal gland:
The procedure is not a permanent solution and does not guarantee that lubricating drops will no longer be needed.
Informed consent: signing a form stating that the treatment is experimental, with its costs and risks, in compliance with the Ministry of Health requirements of each country in this regard.
Pre-procedure tests: a complete blood count is required to assess platelet count and function, and to confirm that the eye and eyelid are free of any active bacterial infection.
Cost: medical insurance companies usually do not cover this procedure because it is not registered as a proven indication.
Possible side effects and complications of PRP injection into the lacrimal gland:
Common and temporary (may resolve within days):
Pain and pressure at the injection site in the upper eyelid.
Temporary swelling of the eyelid.
Skin bruising or mild subconjunctival bleeding.
Temporary fluctuation and blurring of vision for a few hours after the injection.
Less common and more serious:
Bleeding or subconjunctival hemorrhage.
Injury to the tear ducts.
Bacterial infection of the lacrimal gland.
Temporary drooping of the upper eyelid.
A transient severe inflammatory reaction due to the tissue response to the released growth factors.
How PRP injection into the lacrimal gland is performed:
The injection is performed in the outpatient clinic or a minor operating room under fully sterile conditions, following these steps:
1. Preparation and blood draw:
Drawing the blood sample.
Separation by centrifugation.
Extracting the platelet-rich plasma layer and filling it into small sterile syringes.
2. Anesthesia and sterilization:
Topical anesthesia: an anesthetic eye drop is applied.
Anesthesia of the injection site: a topical anesthetic (lidocaine gel) is applied.
Sterilization: the eyelid and the outer surface of the eye are sterilized with a diluted ophthalmic povidone-iodine (Betadine) solution.
3. Injection technique:
0.5 to 1.0 ml of plasma is injected, and the gland is reached in one of two ways:
Transconjunctival approach.
Transcutaneous (through the skin) approach.
Ultrasound guidance during PRP injection into the lacrimal gland is an advanced technical option for reaching the gland precisely.
4. Care immediately after the procedure:
Local pressure: for 1 to 2 minutes to reduce bruising or bleeding.
Preventive drops: an antibiotic drop is prescribed for 3 to 5 days to prevent infection.
Post-injection instructions:
Avoid rubbing the eye or pressing on the upper eyelid.
Apply cold compresses to the eyelid to reduce swelling and discomfort during the first 24 hours.
References
1. Avila MY. Restoration of human lacrimal function following platelet-rich plasma injection. Cornea. 2014;33(1):18-21. doi:10.1097/ICO.0000000000000016
2. Mohammed MA, Allam IY, Shaheen MS, et al. Lacrimal gland injection of platelet rich plasma for treatment of severe dry eye: a comparative clinical study. BMC Ophthalmol. 2022;22(1):343. doi:10.1186/s12886-022-02554-0
3. Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. Am J Ophthalmol. 2025;279:289-386. doi:10.1016/j.ajo.2025.05.039