Abstract
Purpose: :
To describe the experience of a cornea referal with use of autologous serum from 2003 to 2007.
Methods: :
A total of 81 patients have been treated with autologous serum. 32 patients with dry eye, 17 with herpetic keratitis, 6 with penetrating keratoplasty, 10 with allergic conjunctivitis, 10 with vernal keratoconjuntivitis, 6 with recurrent epithelial defects in a 4 year period. We obtain the autologous serum in our hospital following some steps: under aseptic conditions and prior informed consent, extracted blood in 2 vacutainer tubes (30 ml) without anticoagulant, clot formation for 1 hour, centrifuge tubes at 3500 RPM for 10 minutes, getting at least 3 ml blood serum, serum dilution of 20%. Prepared two eyedroppers previously sterilized, diluting 1.5 ml of serum in 6 ml of balanced saline solution. Success rate in our patients was about 80%, except in patient with herpetic keratitis.
Results: :
We know that the autologous serum was useful in differents pathologies: for epithelial defect, one patient was resolved it in 2 weeks, in 4 patients about 2 to 4 weeks and there was no improvement in 1. Allergic conjunctivitis, showed a marked improvement of symptoms after a month. In dry eye, 7 patients disappeared conjunctival hyperemia, and in 5 it was mild. The foreign body sensation decreased significantly in 11 patients. The tear break up time increased from 3.5 to 4.4 seconds and the percentage of superficial punctate keratitis decreased from 32 to 29%. 5 Patients with penetrating keratoplasty had a successful surgery using autologous serum. In patients with vernal keratoconjunctivitis we found mean decrease of 79% of symptoms and 67% of the clinical signs at the end of treatment. Most of the signs and symptoms were presented in symmetrical form. Success rate was considered was: in dry eye 71%, in epithelial defect 83%, in allergic conjunctivitis 100%, in penetrating keratoplasty 83%, vernal keratoconjunctivitis 79% and none of the patients with herpetic keratitis had good evolution.
Conclusions: :
Autologous serum is an alternative therapy in persistent corneal defects and allergic conjunctivitis offering improvement of symptoms and time resolution. In patients who underwent penetrating keratoplasty improve their ocular surface. In severe dry eye, autologous serum provides better clinical signs and symptoms than lubricants.
Keywords: cornea: clinical science • cornea: tears/tear film/dry eye • ocular irritants