By David Douglas
WESTPORT, CT (Reuters Health) – Autologous serum eyedrops are useful in treating keratoconjunctivitis sicca (KCS) and persistent epithelial defects, according to UK researchers.
John K. G. Dart of the Institute of Ophthalmology in London and colleagues note that there is evidence that serum drops are helpful in treating dry eyes. This may be so "because of the presence of substances that enhance epithelial growth and health." Such substances, Dart told Reuters Health, "are present in natural tears but not in simple lubricant substitutes."
To evaluate the efficacy and safety of using serum in this way, the researchers conducted a pilot study of patients with KCS and with persistent epithelial defects, which were unresponsive to conventional treatment. The findings were published in the October issue of the British Journal of Ophthalmology.
Autologous serum was used in 15 eyes of 13 patients with the epithelial defects. Of these, 9 healed in a mean of 29 days and 6 failed to respond. Epithelial defects recurred in 5 eyes after cessation of serum therapy.
Serum was also used in 11 eyes of 9 patients with KCS. In 2 patients this was started after penetrating keratoplasty. Overall, 6 had improved subjective and fluorescein scores and 5 had improved rose bengal scores.
In the 2 patients who underwent keratoplasty, postoperative cessation of the drops led to a fall in subjective and objective scores. One patient developed a persistent epithelial defect that responded to reinstitution of the drops.
Furthermore, in vitro studies showed that the viability of human corneal epithelial cells exposed to serum drops was superior to that achieved with the pharmaceutical tear substitute hypromellose.
In conclusion, the researchers characterize their results as "favorable," and Dart pointed out that for patients with severe dry eyes, the implications are "potentially substantial."
However, he added that "the down side of serum used in this way is that production is very labor-intensive and there is a real risk of contamination by bacteria. The challenge is to provide a serum substitute that can be manufactured and made available on a much wider basis without the need for human blood products."
Br J Ophthalmol 2001;85:1188-1197.
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