Abstract
Purpose: :
To evaluate the efficacy and safety of topical autologous serum in the treatment of patients who underwent high risk penetrating keratoplasty (PKP)
Methods: :
We included patients with high risk factors for graft rejection who underwent PKP from March to October 2005. Autologous Serum was obtained from a 20 mililiter of blood sample, centrifuged and diluted according to Tsubota's technique. Six test tubes with 1 ml each were kept frozen at –70 °C and every week one of them unfrozen diluted with BSS and administered to the patient. The study group was treated with 20% diluted autologous serum eyedrops 4 times a day in addition to steroid therapy since the first day postoperative. PKP technique was with separate stitches Epithelial characteristics, pachometry (optical), presence of vascularization (grade 1 vessels overcome the limbus, grade 2 between suture and donor edge, grade 3 overcome donor edge, grade 4 invasion of corneal graft), uncorrected visual acuity, intraocular pressure, edema , pain , hyperemia were reported preoperative and postoperative every week for 6 months. Time and presence of rejection was recorded.
Results: :
We included 6 patients, mean follow–up time was 20 weeks (range 15–22). Two weeks after surgery, 3 cases had intact and clear epithelial layer and 3 had mild punctuate keratitis. Only one case had vascularization grade 2, the remaining cases had no vascularization. Mean first week postoperative pachometry was 600 µ and 550 µ at 6 month postoperatively in 5 cases. Five of the six patients responded well to treatment (83.3%) and only one patient (16.6%) had graft rejection at 7th week after surgery. No side effects were noted in any of the treated patients
Conclusions: :
Autologous serum application is a safe and efficient way to provide a good ocular surface which may contribute to decrease the incidence of graft failure during the first 6 months of follow–up.
Keywords: transplantation • cornea: tears/tear film/dry eye • cornea: clinical science