Abstract
Purpose: :
During the last ten years eye drops made from autologous serum have become an established therapy for various ocular surface disorders. However, in the EU serum eye drops can only be dispensed to outpatients by institutions which have obtained a specific license from the local authorities. Albumin is the main protein component in tears and is commercially available as a quality controlled product from the pharmaceutical industry. The aim of this study was to analyse if albumin eye drops are an effective replacement treatment for serum in severe ocular surface diseases such as corneal ulcers (CU) and persistent epithelial defects (PED).
Methods: :
15 eyes with CU and 9 eyes with PED were treated with 5% albumin eye drops 8 times daily. Mean patient age was 58.8 ± 21.5 years. 11 men and 12 women were treated. Of the 15 CUs 5 were of trophic, 3 of toxic, 3 of postinfectious, 2 of rheumatic and 2 of aqueous deficient etiology. 10 CUs were pretreated with 100% serum eye drops hourly for 18 ± 15.9 days during hospitalisation before this therapy was substituted with 5% albumin eye drops. Over a mean follow-up of 2.2 ± 1.9 months visual acuity (Snellen), corneal epithelial staining (Oxford grading scale) and complications such as recurrence of PED or CU were recorded. For control the medical notes of 15 patients with CU and 8 patients with PED of matching etiology who had been treated with commercially available lubricants were reviewed.
Results: :
During treatment with albumin eye drops 2 recurrences of CU were noted. In the 13 CUs (87 %) and 9 PEDs (100 %) remaining the ocular surface was stable. Corneal epithelial staining improved from a mean of III° to I° during follow-up. In the control group 7 CUs (47 %) and 1 PED (12.5 %) relapsed during follow-up. This difference was significant (p≤ 0.05).
Conclusions: :
This case control study showed that albumin eye drops are able to maintain corneal epithelial health following CU or PED better than pharmaceutical tear substitutes.
Keywords: cornea: clinical science • wound healing • anterior segment