Use Of Autologous Serum Eye Drops Research Articles

Efficacy and safety of intrastromal injection of amphotericin B combined with autologous serum eye drops in resistant fungal corneal ulcers

Aim The aim was to evaluate the efficacy of a combination of intrastromal injections of amphotericin B (AmB) and autologous serum eye drops (ASED) in the treatment of resistant fungal keratitis. Patients and methods This is a prospective nonrandomized study that evaluated 15 eyes of 15 patients with resistant fungal corneal ulcers not responding to conventional medical treatment treated with intrastromal AmB injection (25 µg/ml) combined with the use of ASED. The efficacy, complications, and outcomes were evaluated. Results Patients showed marked improvement in symptoms (e.g. pain, discharge, photophobia, and lacrimation) in 12 cases (80%) by the second week after injection and total disappearance of symptoms in all patients by the second month. By the second week, three eyes (20%) showed complete ulcer healing, at the first month eight eyes (53.3%), at the second month 12 eyes (80%), and at the third month 15 eyes (100%) showed complete ulcer healing. The procedure was performed successfully, and no severe intraoperative or postoperative complications were observed except two patients develop minimal intrastromal bleeding which resolved. All the study cases underwent use of ASED after the intrastromal injection to accelerate ulcer healing, alleviate corneal irritation, and reduce inflammatory reactions and all of them showed rapid improvement of symptoms, for example, pain and good ulcer-healing process. Conclusion Combination of intrastromal injection of AmB and autologous serum eye drops is a promising, safe, and effective technique for the management of resistant fungal corneal ulcers not responding to conventional medical treatment. ASED shows good results in improving epithelial healing, alleviating corneal irritation, and in reducing inflammatory reactions.

The use of autologous serum eye drops for the treatment of ocular surface disorders

ObjectivesTo investigate the use of autologous serum (AS) eye drops in patients with ocular surface disorders who were refractory to conventional treatments.MethodsA retrospective cohort study was conducted at a tertiary...

Safety and efficacy of autologous serum eye drop for treatment of dry eyes in graft-versus-host disease

Purpose: To evaluate the treatment of autologous serum eye drops (ASED) on dry eyes in patients with graft-versus-host disease (GVHD).Methods: A retrospective chart review of 35 patients with a history of ocular GVHD following hematopoietic stem cell transplantation that used ASED to alleviate dry eye symptoms was performed. Patients were categorized into three different groups. If patients had available ophthalmic data before and after starting treatment was group 1 (n = 14), had available ophthalmic data after starting treatment in group 2 (n = 10) and had available ophthalmic data before treatment or did not have any data after starting treatment in group 3 (n = 11). Data were collected on patient’s age, gender, primary diagnosis, visual acuity and fluorescein corneal staining were collected on individual eyes in order to evaluate the efficacy of the ASED on alleviating dry eye-related signs and symptoms.Results: No adverse ocular effect from the ASED was found in our series (except one fungal keratitis). All patients reported either improvement (55%) or stability (45%) in their ocular symptoms upon the use of ASED. In patients with available data before and after starting treatment, the corneal staining score improved by a median of 1 (p = 0.003) and the LogMAR visual acuity had a non-significant improvement.Conclusion: In our study, ASED used by patients with ocular GVHD were both safe and effective. ASED should be considered in patients with GVHD who suffer from dry eyes.

A protocol for microbiologically safe preparation, storage, and use of autologous serum eye-drops in low-income countries.

The study aimed to investigate whether the preparation, storage, and use of autologous serum in insulin syringes is microbiologically safe. Blood samples (10 mL) were obtained from 10 volunteers. After centrifugation, the supernatant serum was removed and distributed in 5 sterile insulin syringes for each sample; syringes were numbered 0 to 4 and labelled with the subject's details. Syringes were immediately transported to the microbiology laboratory and stored in a refrigerator at +4°C. The "0" labelled syringes were separated from the others and 100 µl of serum from each syringe was immediately seeded on chocolate and Sabouraud agar plates, which were incubated aerobically at 37°C for 96 hours to detect any bacterial and/or fungal contamination. In the next 4 days, the same procedure was repeated for the remaining syringes: on day 1, the "1" labelled syringes were analyzed; on day 2, the "2" labelled ones, and so on. In a second experiment, blood samples were obtained from 5 different volunteers. The same procedure as above was followed, but each syringe was used for repeated cultures at 2-hour intervals, for a total of 12 cultures/day. The needle was removed and replaced for each inoculation and the syringes were stored in the refrigerator after use. Under these experimental conditions, none of the cultures showed microbial growth. Results suggest that, under the protocol described, preparation, storage and use of undiluted autologous serum in insulin syringes is inexpensive, fast, and microbiologically safe. This is of great importance for low-income countries.

Management of Bullous Keratopathy-Related Ulcer With Autologous Serum

The aim of this study was to report the use of autologous serum eyedrops (ASEs) for resolution of a corneal ulcer secondary to bullous keratopathy. This is a case report. A 66-year-old patient presented with an infected ulcer and hypopyon while using a bandage contact lens for bullous keratopathy. Staphylococcus warneri infection was treated with systemic and topical antibiotics, and ASEs were subsequently administered to enhance reepithelialization and to avoid the need for a bandage contact lens. The ASE treatment led to closure of the epithelium layer within 3 weeks, and it was subsequently tapered over the next 3 months. The clinical picture remained stable subjectively and objectively during the 7 months of follow-up. To the best of our knowledge, this is the first report of successful use of ASEs in treating and preventing recurrence of ulcers in the context of bullous keratopathy.

Use of Autologous Serum Eyedrops for the Treatment of Ocular Surface Disease: First US Experience in a Large Population as an Insurance-Covered Benefit

Use of Autologous Serum Eyedrops for the Treatment of Ocular Surface Disease: First US Experience in a Large Population as an Insurance-Covered Benefit

Autologous Serum Eyedrops in the Treatment of Aniridic Keratopathy

To study the effect of autologous serum eyedrop application in aniridic keratopathy. Prospective, consecutive, comparative, interventional case series. Twenty-six eyes from 13 patients (7 males and 6 females) with aniridic keratopathy treated with autologous serum eyedrops. All patients underwent a complete ophthalmic examination. The ocular surface examinations included corneal impression cytologic analysis and tear film evaluation. The eyes were divided into 4 groups according to the Mackman classification. Ocular surface photography was used to evaluate the corneal surface and tear film before treatment and every 2 or 3 days until serum drops were stopped. Tear films were evaluated by tear film break-up time (BUT) (normal, 10 seconds or more), Schirmer's test with anesthesia (normal, 10 mm/5 minutes or more), tear meniscus level (normal, 0.5 mm or more), and rose bengal and fluorescein staining pattern of the cornea. Impression cytologic analysis was carried out both before starting the serum eyedrops treatment and a few days after its finalization. Tear film production and stability, corneal epithelialization, and corneal epithelium squamous metaplasia. There were no local side effects from autologous serum treatment. Clinical manifestations and slit-lamp findings were in relation to the severity of keratopathy. All patients showed a subjective improvement of keratopathy symptoms after the autologous serum applications. The corneal epithelialization, corneal epithelial cell squamous metaplasia, and tear stability improved significantly with the treatment, but visual acuity, regression of vascular pannus, and subepithelial scarring showed only slight improvement with treatment. Autologous serum eyedrops improved the aniridic keratopathy in all patients, particularly in patients with light or moderate severity. In these patients, use of autologous serum eyedrops was superior to conventional therapy with substitute tears for improving the ocular surface and subjective comfort.

Combination of transepithelial phototherapeutic keratectomy and autologous serum eyedrops for treatment of recurrent corneal erosions

The authors performed a nonrandomized, prospective, interventional clinical trial to evaluate the clinical outcome of the treatment of recurrent corneal erosions with a combination of transepithelial phototherapeutic keratectomy (t-PTK) and autologous serum eyedrops. Twenty-five eyes of 25 patients with a history of three to 12 post-traumatic, recurrent corneal erosions were treated with t-PTK using two bursts of 40 pulses (ablation depth 18.82 ± 2.56 μm using a 6.0 mm beam centered on the affected area. The median patient age was 40.6 years ± 12.0. Postoperatively, autologous serum eyedrops were administered six times daily for 6 weeks. The median follow-up was 15.5 months (range, 6 to 20 months). During the follow-up period, no patient had a change in refraction and no inflammatory or allergic reactions occurred. Twenty (80%) eyes had no further corneal erosions. Five eyes had corneal erosion, which was successfully treated in four eyes without further recurrence with continued use of autologous serum eyedrops without additional excimer laser treatment. One patient requested additional t-PTK treatment and recovered without further corneal erosions. The authors confirmed previous observations that t-PTK is an effective modality for the treatment of recurrent corneal erosions. They also postulate that their data suggests that autologous serum may be given as long-term artificial treatment postoperatively.—Michael D. Wagoner