Abstract
Purpose::
Autologous serum eyedrops have recently been suggested to be efficacious in the treatment of various ocular surface disorders including persistent epithelial defects and dry eyes. For these conditions, authors have utilized concentrations of autologous serum ranging from 20% to 100%. The aim of this study was to evaluate the efficacy of treating persistent epithelial defects and dry eyes utilizing 50% autologous serum eyedrops.
Methods::
A retrospective chart review was performed of all patients during a 26-month period who underwent treatment with 50% autologous serum eyedrops for a persistent epithelial defect or dry eyes that was non-responsive to conventional medical treatment.
Results::
Persistent epithelial defects: Twenty-three eyes of 22 patients failed conventional medical therapy for treatment of a persistent epithelial defect and were treated with 50% autologous serum eyedrops every two hours while awake. All corneas were neurotrophic, with the etiologies being herpetic (11 eyes), post-keratoplasty (6 eyes), post-keratorefractive surgery (3 eyes), diabetic (1 eye), and unknown (2 eyes). The median duration of the epithelial defects prior to initiation of autologous serum eyedrops was 6.4 weeks (range 1-52 weeks). Eighteen eyes (78.3%) healed within 4 weeks (mean 1.8 weeks) of starting therapy with 50% autologous serum eyedrops. One of the 18 eyes which healed initially with 50% autologous serum eyedrops developed a recurrence of the epithelial defect when the eyedrops were tapered to twice daily. Of the 5 eyes which did not heal completely within 4 weeks of starting 50% autologous serum eyedrops, all of the epithelial defects decreased significantly in size during the treatment period. No cases of infectious keratitis occurred in any of the eyes treated. Dry eyes: Twenty eyes of 10 patients failed conventional medical therapy for treatment of dry eyes and were treated with 50% autologous serum eyedrops every two hours while awake. The etiologies for dry eyes were post-menopausal (4 patients), chronic graft-verus-host disease (3 patients), Sjogren’s syndrome (2 patients), post-keratorefractive surgery (1 patient). Sixteen eyes of eight patients noted significant symptomatic relief associated with decreased ocular surface staining.
Conclusions::
The use of 50% autologous serum eyedrops appears to be a safe and efficacious medical treatment modality for persistent epithelial defects and dry eyes that are recalcitrant to conventional medical therapy.
Keywords: cornea: epithelium • cornea: tears/tear film/dry eye • cornea: clinical science