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B. H. Jeng, W. J. Dupps, Jr.; Relationship Between Duration of Persistent Epithelial Defects and Healing Time After Initiation of Treatment With Autologous Serum Eyedrops. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2348.
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To determine whether the healing time of persistent epithelial defects after initiation of autologous serum eyedrop therapy is related to the duration of the defect prior to this intervention.
We reviewed the medical records of all patients seen at our institution from September 2004 to May 2007 with persistent epithelial defects (PED) that were non-responsive to conventional medical treatment and that were treated with 50% autologous serum eyedrops. We performed a regression analysis to explore a potential linear relationship between pre-serum defect duration and healing time. The influence of defect etiology on healing time was also explored in a single-predictor regression model and in a multivariate model that included both pre-serum defect duration and etiology as predictors.
Twenty-five eyes of 25 patients failed conventional medical therapy for treatment of a PED and were treated with 50% autologous serum eyedrops every two hours while awake. The mean duration of the epithelial defects prior to initiation of autologous serum eyedrops was 97.3 days. After institution of autologous serum therapy, 23 of the 25 eyes healed in a mean time of 22.4 days. A linear regression model with healing time as the response variable and pre-serum defect duration as the predictor revealed that the number of days required for healing was associated with the length of time the defect was open prior to initiation of serum drops (r = 0.68, p < 0.001):Days to healing = 9.5 + 0.085 * (duration of defect prior to serum therapy).Healing time did not differ significantly for patients with herpetic disease (18 ± 10 days) versus those who were post-keratoplasty (32 ± 37 days) by a two-tailed Student’s t-test (p = 0.4) despite a trend toward longer and more variable healing times in post-keratoplasty patients.
Across all etiologies of PED, the duration of the defect was a predictor of how much time was required to achieve healing with serum. It may be reasonable to consider the use of autologous serum earlier in the course of the disease process to minimize the risks of infection and subepithelial haze associated with prolonged duration of epithelial defects.
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