PURPOSEThe aim was to evaluate the effect of autologous platelet-rich plasma on lacrimal function in patients with severe dry eye.METHODSA prospective interventional case series design was adopted. Four patients with severe lacrimal dysfunction and severe dry eye were treated. Platelet rich-activated plasma (1 mL) was injected adjacent to the lacrimal gland on day 0 and at 4, 8, and 12 weeks. The objective parameters included a Schirmer test, ocular surface staining, and tear break-up time (TBUT). The patients were followed up for 12 weeks after the first injection.RESULTSAll cases showed a significant improvement in lacrimal volume (from 3.3 ± 0.8 mm to 11.1 ± 2.3 mm). In all the patients, an increase in tear break-up time values and a decrease in ocular staining (basal 8.0 ± 0.61-2.8 ± 0.5) with subjective improvement occurred. None of the patients presented any adverse effect, and none reported pain or discomfort. Additionally, no complications were observed.CONCLUSIONSInjected platelet-enriched plasma was found to be safe and effective in increasing lacrimal production and in improving ocular staining secondary to severe dry eye. This approach could be an alternative for the management of these patients, although additional studies are required to perfect the technique.