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Persistent Epithelial DefectNCT03653650

Autologous Platelet-rich Plasma in the Treatment of Persistent Epithelial Defects

A study testing PRP plus BCL, BCL plus PFL and Eye patch plus ocular lubricant ointment in people with Persistent Epithelial Defect, run by Universidad Autonoma de Nuevo Leon at 1 site in Mexico.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Persistent epithelial defects (PED) are corneal ulcers that do not heal within the first two weeks of treatment with artificial tears or ocular lubricant ointment. It is believed that this condition is the result of the loss of certain substances normally present in the tears that aid in the healing process of the… Read more about this study

Who is it for?
Any age
Conditions the study is for
Persistent Epithelial Defect
What is being tested?
PRP plus BCL, BCL plus PFL and Eye patch plus ocular lubricant ointment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
54 participants
Where
1 siteMexico
Study dates
30 Aug 2018to 1 Aug 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with persistent epithelial defect and at least one of the following diagnoses:
  • Recurrent corneal epithelial defect.
  • Neurotrophic corneal ulcer.
  • Neurotrophic keratopathy secondary to any disease (i.e. diabetes mellitus, infection with herpes simplex virus or herpes zoster virus, microbial keratitis sequelae, multiple sclerosis, Parkinson's disease, VII cranial nerve palsy, chemical or thermic burn sequelae, trauma, surgery, iatrogenic, chronic dry eye, rheumatic disease).

Who cannot join

  • Patients diagnosed with:
  • Peripheral ulcerative keratitis, or Mooren's ulcer.
  • Active infectious keratitis and/or ulcers.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Karim Mohamed-Noriega, M.D. contact

+52 8183469259

karim.mohamednrg@uanl.edu.mx

Mexico1 site, 1 recruiting
  • Departamento de Oftalmologia, Hospital Universitario "Dr. Jose Eleuterio Gonzalez"

    Monterrey, Nuevo León, 64460

    Karim Mohamed-Noriega, M.D., +52 81 83469259, karim.mohamednrg@uanl.edu.mx

    Recruiting

Other trials in Mexico

About this study

Official title: Autologous Platelet-rich Plasma in the Treatment of Persistent Corneal Epithelial Defects

Persistent epithelial defects (PED) are corneal ulcers that do not heal within the first two weeks of treatment with artificial tears or ocular lubricant ointment. It is believed that this condition is the result of the loss of certain substances normally present in the tears that aid in the healing process of the cornea. When the eye is healthy, these ulcers typically heal rapidly. However, when there is an underlying disease such as diabetes, this healing process is altered and it takes longer for the ulcer to heal. Autologous platelet-rich plasma (PRP) is a substance that is obtained from the patient's own blood and it is believed this substance may replace those missing factors in the tears of patients with PED. The purpose of this investigation is to find out whether PRP combined with a bandage contact lens is better than preservative free lubricant combined with bandage contact lens or than eye patch with ocular lubricant ointment for the treatment of PED. Participants will be randomly assigned to one of the three groups and will get the treatment until the ulcer heals completely. We will count the days it takes for the PED to heal and based on that we will determine wich treatment is more effective (the treatment that takes the least days to heal will be considered the most effective). Since this disease is difficult to treat and doesn't have a gold standard treatment, usually the available treatments are not as good as we would like, therefore, the ulcer might progress even to perforation regardless of the treatment. In these cases, we will provide appropriate treatment for progressive corneal thinning and corneal perforation.

Read the detailed description

Persistent epithelial defects (PED) are corneal lesions that do not heal within the first two weeks of conventional treatment (i.e. preservative-free lubricant, bandage contact lens (BCL), ocular lubricant ointment, eye patching). These defects are the result of the loss of certain lacrimal factors that maintain the integrity and homeostasis of the corneal epithelium and ocular surface. Normally, PED heal rapidly in the healthy eye. However, underlying ocular surface pathology can slow down the healing process and contribute to the persistence of the epithelial defect. Hematopoietic derivatives such as autologous platelet-rich plasma (PRP) may replace these missing components and eventually lead to complete healing in a faster and more comfortable way for the patient. The objective of this study is to determine if PRP combined with BCL is more effective than preservative-free lubricant combined with BCL or than eye patch with ocular lubricant ointment for the treatment of PED. Participants will be randomly assigned to one of the three groups and treatment will be administered until achieving complete defect closure. The effectiveness of each treatment will be measured in terms of days taken to achieve complete closure. Since PED is a complex disease that is difficult to treat, the available treatments are not very effective, therefore, PED might progress even to perforation regardless of the treatment. In this last scenario, we will provide appropriate treatment for progressive corneal thinning and corneal perforation

Being tested
PRP plus BCL, BCL plus PFL, Eye patch plus ocular lubricant ointment
Keywords
Platelet-Rich Plasma, Persistent Epithelial Defect

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PRP plus BCLCombination product

    Bandage contact lens (BCL) plus 1 autologous platelet-rich plasma (PRP) eye drop every 1 to 3 hours.

  • BCL plus PFLCombination product

    Bandage contact lens (BCL) plus 1 preservative-free lubricant (PFL) eye drop every 1 to 3 hours.

  • Eye patch plus ocular lubricant ointmentCombination product

    Eye patch plus ocular lubricant ointment every 24 hours.

Study groups in NCT03653650
Study groupRoleWhat they receive
PRP plus BCLExperimentalBandage contact lens (BCL) plus 1 autologous platelet-rich plasma (PRP) eye drop every 1 to 3 hours.
Receives: Combination Product: PRP plus BCL
BCL plus PFLActive comparatorBandage contact lens (BCL) plus 1 preservative-free lubricant (PFL) eye drop every 1 to 3 hours.
Receives: Combination Product: BCL plus PFL
Eye patch plus ocular lubricant ointmentActive comparatorEye patch plus ocular lubricant ointment every 24 hours.
Receives: Combination Product: Eye patch plus ocular lubricant ointment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Persistent epithelial defect healing time.

    Persistent epithelial defect healing time measured in days.

    Measured: From the first day of treatment until the date of complete defect closure, assessed up to 3 months.

Secondary outcomes (8)
  1. Change in corneal sensitivity

    Corneal sensitivity will be assessed with corneal esthesiometer Cochet-Bonnet.

    Measured: Change from baseline corneal sensitivity at the date of defect closure, up to 3 months.

  2. Uncorrected visual acuity

    Uncorrected visual acuity will be assessed using Snellen cards. Measurements will be converted to LogMar values for statistical analysis.

    Measured: Every week (or sooner, if needed) from date of randomization until the date of complete defect closure, up to 3 months.

  3. Best corrected visual acuity

    Best corrected visual acuity will be assessed using Snellen cards. Measurements will be converted to LogMar values for statistical analysis.

    Measured: Every week (or sooner, if needed) from date of randomization until the date of complete defect closure, up to 3 months.

  4. Ocular pain

    Ocular pain will be assessed using the Wong-Baker Faces Pain Rating Scale. The scale ranges from 0 (no pain) to 10 (maximum pain), and includes 6 faces (visual representation), numbers, and written descriptions that represent the level of pain. The first face represents a pain score of 0 and it reads "no hurt"; the second face represents a pain score of 2 and it reads "hurts little bit"; the third face represents a pain score of 4 and it reads "hurts little more"; the fourth face represents a pain score of 6 and it reads "hurts even more"; the fifth face represents a pain score of 8 and it reads "hurts whole lot"; the last face represents a pain score of 10 and it reads "hurst worst". Lower values represent a better outcome.

    Measured: Every week (or sooner, if needed) from date of randomization until the date of complete defect closure, up to 3 months.

  5. Ocular surface symptoms

    Ocular surface symptoms as assessed by the Symptom Assessment in Dry Eye (SANDE) questionnaire. The SANDE questionnaire consists of two questions presented in visual analog scale. The first question assesses the frequency of dry eye syndrome and the scale ranges from "rarely" to "all the time" on a 100 mm line. The second question assesses the severity of dry eye syndrome and the scale ranges from "very mild" to "very severe" on a 100 mm line. Patients are asked to place a mark on the line to represent the extent of their symptoms, then the location of the marks on each line are measured from left to right in mm. The SANDE score is calculated by multiplying the frequency value times the severity value and obtaining the square root. Lower scores represent a better outcome.

    Measured: Every week (or sooner, if needed) from date of randomization until the date of complete defect closure, up to 3 months.

  6. Ocular surface symptoms

    Ocular surface symptoms as assessed by the Ocular Surface Disease Index (OSDI). The OSDI questionnaire consists of 12 questions that assess dry eye symptoms and their effects on vision related function. The questionnaire is divided in 3 subscales: ocular symptoms, vision-related function, and environmental triggers. Patients are asked to rate their responses on a 0 to 4 scale where 0 represents "none of the time", 1 "some of the time", 2 "half of the time", 3 "most of the time", and 4 "all of the time". The total score is calculated using the following formula: ([sum of scores for all questions answered x 100] / [total number of questions answered x 4]). Lower scores represent a better outcome.

    Measured: At date of randomization and at date of defect closure, up to 3 months.

  7. Quality of life questionnaire

    Quality of life as assessed by the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). The NEI VFQ-25 questionnaire consists of 25 questions that assess the effect of visual impairment on the patient's quality of life. The 25-item questionnaire gives a score on a scale of 0 to 100, where 0 is the worst score and 100 is the best score. Higher scores represent a better outcome.

    Measured: At date of randomization and at date of defect closure, up to 3 months.

  8. Frequency of adverse events, recurrences and/or treatment failure

    Frequency of adverse events, recurrences and/or treatment failure will be evaluated during the ophthalmic evaluation.

    Measured: These will be evaluated from the beginning of the treatment until three months after defect closure.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Aug 2018
  2. Study start30 Aug 2018
  3. Primary completionAug 2027 (estimated)
  4. Study completion1 Aug 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Subjects will be randomly assigned to three groups. Demographic characteristics and underlying etiologies will be identified. Subjects will undergo a general ophthalmologic evaluation (baseline) and PED size will be measured. Treatments will be administered until complete defect healing is achieved and visits will be scheduled weekly or as needed for continued ophthalmologic evaluation. After complete closure, subjects will be followed for three months with visits every 2 to 4 weeks to evaluate progress and identify recurrences.
Masking
None (open label)
Enrolment
54 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03653650
Sponsor's protocol ID
OF18-00003
Status last verified
May 2026
First submitted
16 Aug 2018
Last updated
6 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Tsubota K, Goto E, Shimmura S, Shimazaki J. Treatment of persistent corneal epithelial defect by autologous serum application. Ophthalmology. 1999 Oct;106(10):1984-9. doi: 10.1016/S0161-6420(99)90412-8.

    PubMed 10519596
  • Chen J, Chen P, Backman LJ, Zhou Q, Danielson P. Ciliary Neurotrophic Factor Promotes the Migration of Corneal Epithelial Stem/progenitor Cells by Up-regulation of MMPs through the Phosphorylation of Akt. Sci Rep. 2016 May 13;6:25870. doi: 10.1038/srep25870.

    PubMed 27174608
  • Ljubimov AV, Saghizadeh M. Progress in corneal wound healing. Prog Retin Eye Res. 2015 Nov;49:17-45. doi: 10.1016/j.preteyeres.2015.07.002. Epub 2015 Jul 18.

    PubMed 26197361
  • Nugent RB, Lee GA. Ophthalmic use of blood-derived products. Surv Ophthalmol. 2015 Sep-Oct;60(5):406-34. doi: 10.1016/j.survophthal.2015.03.003. Epub 2015 Apr 15.

    PubMed 26077627
  • Alio JL, Rodriguez AE, WrobelDudzinska D. Eye platelet-rich plasma in the treatment of ocular surface disorders. Curr Opin Ophthalmol. 2015 Jul;26(4):325-32. doi: 10.1097/ICU.0000000000000169.

    PubMed 26058033
  • Alio JL, Abad M, Artola A, Rodriguez-Prats JL, Pastor S, Ruiz-Colecha J. Use of autologous platelet-rich plasma in the treatment of dormant corneal ulcers. Ophthalmology. 2007 Jul;114(7):1286-1293.e1. doi: 10.1016/j.ophtha.2006.10.044. Epub 2007 Feb 26.

    PubMed 17324465
  • Kim KM, Shin YT, Kim HK. Effect of autologous platelet-rich plasma on persistent corneal epithelial defect after infectious keratitis. Jpn J Ophthalmol. 2012 Nov;56(6):544-50. doi: 10.1007/s10384-012-0175-y. Epub 2012 Sep 13.

    PubMed 22972393

Questions about this trial

What is this clinical trial studying?

A study testing PRP plus BCL, BCL plus PFL and Eye patch plus ocular lubricant ointment in people with Persistent Epithelial Defect, run by Universidad Autonoma de Nuevo Leon at 1 site in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Karim Mohamed-Noriega, M.D. (+52 8183469259, karim.mohamednrg@uanl.edu.mx), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Persistent epithelial defect healing time. (time frame: From the first day of treatment until the date of complete defect closure, assessed up to 3 months.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03653650, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.

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