Subconjunctival autologous platelet-rich plasma as an adjunctive therapy for limbal-scleral ischemia following acute ocular burns: a prospective randomized pilot trial.

PURPOSE: To evaluate the feasibility and short-term outcomes of subconjunctival injection of autologous platelet-rich plasma (PRP) as an adjunct to topical PRP for limbal-scleral ischemic area (LSIA) following acute ocular burns. METHODS: This prospective randomized pilot study included patients with LSIA within three weeks of chemical or thermal ocular burns. Sixteen eyes of 16 patients were randomized using permuted block randomization into two groups. Both groups received standard medical therapy including topical PRP eye drops. The intervention group additionally received a single session of subconjunctival PRP injection. Limbal-scleral ischemic area (LSIA) was quantified using ImageJ. Best-corrected visual acuity (BCVA) at 3 months was analyzed as a primary outcome. The secondary outcome was change in LSIA size and time to complete revascularization. RESULTS: Sixteen eyes of 16 patients (mean age 35.37 ± 11.42 years; all male) were included. Mean BCVA improved from 1.44 ± 0.70 to 1.07 ± 0.95 logMAR (p > 0.05). Baseline LSIA was 57.03 ± 28.68 mm2 in Group 1 and 55.83 ± 28.63 mm2 in Group 2 (p = 0.916). Complete vascularization and healing occurred in both groups by month three. Mean healing time was 50 days (95% CI: 17.9-82.1) in Group 1 and 44.75 days (95% CI: 20.0-69.5) in Group 2. No injection-related adverse events were reported. CONCLUSION: Subconjunctival autologous PRP appears feasible and safe as an adjunct to topical PRP in acute ocular burns. However, no significant benefit in LSIA healing was demonstrated, and larger controlled trials are required to determine efficacy. TRIAL REGISTRATION: This clinical trial was retrospectively registered with the Iranian Registry of Clinical Trials (IRCT; registration number: IRCT20231219060471N3 on July 30, 2026.