Human Serum Eye Drops in Eye Alterations: An Insight and a Critical Analysis

Human serum contains a physiological plethora of bioactive elements naturally released by activated platelets which might have a significant effect on the regeneration of corneal layers by stimulating the cell growth. This mechanism supported the use of human serum eye drops in some ocular diseases associated with dystrophic changes and alterations of the tear film, such as persistent corneal epithelial defects and dry eye syndrome. We focused our effort on potential benefits and limitations of the use of human serum eye drops when conventional therapies failed. We reviewed the recent literature by reporting published studies from 2010 to 2014. Despite the limited evaluated study populations, most of the clinical studies have confirmed that serum eye drop therapy is effective in corneal healing by reducing ocular symptom, particularly during the short-term follow-up. In addition, three recent published studies have shown the efficacy of the serum eye drop therapy in comparison to traditional ones in intractable patients. Besides, reported ongoing clinical studies confirmed the open debate regarding the use of biologic tools for cornea regeneration. Results from these studies might open novel challenges and perspectives in the therapy of such refractory patients.

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Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery

BioMed Research International ◽

10.1155/2013/521315 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 25

Author(s):

Kaevalin Lekhanont ◽

Passara Jongkhajornpong ◽

Lulin Choubtum ◽

Varintorn Chuckpaiwong

Keyword(s):

Complete Healing ◽

Autologous Serum ◽

Eye Drops ◽

Epithelial Defect ◽

Ocular Surgery ◽

Corneal Epithelial ◽

Corneal Epithelial Defect ◽

Conventional Medical Therapy ◽

Serum Eye Drops

The purpose of this study was to investigate the efficacy and safety of topical 100% serum eye drops for corneal epithelial defect after ocular surgery. A total of 181 patients who received topical 100% serum therapy for the treatment of corneal epithelial defect following several different types of ocular surgery were recruited into this study. Each patient already failed conventional medical therapy before being prescribed 100% serum eye drops. Slit-lamp biomicroscopic examination with fluorescein staining was performed at baseline and all follow-up visits. The main outcome measures were the rate of complete healing of the corneal epithelial defect and incidence of adverse events. One hundred and seventy-eight eyes (98.34%) received autologous serum eye drops, and 3 (1.66%) received allogeneic serum eye drops. The overall success rate of treating persistent postoperative epithelial defect using 100% serum eye drops was 93.92% (95% CI 0.88–0.98). The median time to complete corneal epithelialization was 4 days (95% CI 4-5). Adverse reactions were observed in 3 patients (1.66%), including sticky sensation with minimal eye discomfort and asymptomatic trace corneal subepithelial infiltration. No serious complications were reported. In conclusion, 100% serum eye drops are effective, safe, and tolerable for treating postoperative corneal epithelial defect following ocular surgeries.

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Treatment of persistent epithelial defects with single-dose autologous serum eye drops

European Journal of Ophthalmology ◽

10.1177/11206721211048372 ◽

2021 ◽

pp. 112067212110483

Author(s):

Selma Özbek-Uzman ◽

Züleyha Yalnız-Akkaya ◽

Evin Şingar Özdemir ◽

Ayşe Burcu

Keyword(s):

Single Dose ◽

Healing Time ◽

Autologous Serum ◽

Eye Drops ◽

Artificial Tears ◽

Duration Of Treatment ◽

The Mean ◽

Preservative Free ◽

Serum Eye Drops

Purpose: We aimed to investigate the efficacy and safety of single-dose autologous serum eye drops (ASEDs) for treatment of persistent corneal epithelial defects (PEDs). Methods: About 34 eyes of 26 patients treated from March 2016 to May 2020 with a single dose of ASEDs for PEDs that did not respond to conventional treatment were retrospectively evaluated. Patient demographics, predisposing factors, size, and duration of the PED, duration of treatment, and dosage of ASEDs, PED healing time, success rate of the ASED treatment, and follow-up time after the onset of ASED treatment were recorded. Autologous serum eye drops (20%) were prepared by diluting the serum with preservative-free artificial tears in single-dose vials. Vials were stored at −20°C and used daily after dissolving. Results: The mean patient age was 47.0 ± 18.5 years, and 13 (50%) of the patients were male. The most common indication for ASEDs was PED after keratoplasty. The mean duration of ASED treatment was 8.5 ± 6.3 months, and mean follow-up time was 22.8 ± 12.2 months. Autologous serum eye drop treatment was effective in 25 (73.5%) eyes and partially effective in 5 (14.7%) eyes. None of the eyes displayed complications related to the treatment. Conclusion: In patients with PED for whom conservative treatment is insufficient, ASEDs prepared by dilution with preservative-free artificial tears in single-dose vials and administered based on the daily use principle appear to be effective and safe.

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Zdravljenje glavkoma in suho oko

Slovenian Medical Journal ◽

10.6016/zdravvestn.1531 ◽

2016 ◽

Vol 85 (4) ◽

Author(s):

Barbara Cvenkel

Keyword(s):

Ocular Surface ◽

Clinical Signs ◽

Tear Film ◽

Signs And Symptoms ◽

Surface Damage ◽

Eye Drops ◽

Film Instability ◽

Asymptomatic Patients

Patients with glaucoma have increased prevalence of dry eye (DE) compared to age-matched population without glaucoma. Clinical presentation of DE varies among individuals and may significantly reduce quality of life. The onset and deterioration of DE is caused by the toxic-inflammatory effects of preservatives in eye drops, active substance itself, and added, pharmacologically inactive substances or excipients. Ocular surface changes most frequently include superficial punctate keratitis, tear film instability, and allergic reactions. Despite the lack of symptoms, clinical signs may indicate ocular surface damage. Discordance between signs and symptoms is partly caused by decreased corneal sensitivity induced by neurotoxicity of the preservative benzalkonium chloride (BAK). Therefore, it is important to evaluate ocular surface before initiating glaucoma therapy and during follow-up also in asymptomatic patients. Preservative-free and/or BAK-free therapy is indicated in patients with severe DE and allergy to preservatives, and recommended in patients with DE of moderate severity, blepharitis, in symptomatic patients, before filtering surgery to reduce preoperative inflammation, in those with moderate fluorescein staining of grade 2 on Oxford scheme, and reduced tear film break-up time.

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Autologous Serum Eye Drops for Post-Chemical Injuries and Corneal Epithelial Defects

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2013.009 ◽

2013 ◽

Vol 1 (1) ◽

pp. 45-49

Author(s):

Mirjana A. Janicijevic-Petrovic ◽

Marko Petrovic ◽

Dragan Vujic ◽

Katarina Janicijevic ◽

Andrijana Popovic

Keyword(s):

Success Rate ◽

Conventional Treatment ◽

Complete Healing ◽

Autologous Serum ◽

Eye Drops ◽

Epithelial Defect ◽

Corneal Epithelial ◽

Chemical Injuries ◽

Serum Therapy ◽

Serum Eye Drops

Aim: To evaluate success rate (efficacy, safety) in treatment of post-chemical injuries and corneal defects using autologous serum eye drops.Material and Methods: Authors reviewed 93 patients (116 eyes) hospitalized in Clinic of ophthalmology from 2010 to 2013, who had post-causoma corneal defects that were nonresponsive to conventional treatment and were treated with serum therapy. Authors correlated time of epithelialization of defects with rate of epithelial healing.Results: Authors investigated 93 patients (52 males, 41 females; aged 18 - 74) for treatment of corneal defects. Application of autologous serum therapy 56 (48.28%) of 116 eyes was healed in an average time of 4 weeks. Among 116 eyes, epithelial defects healed in 4 (3.45%) within 1 week, in additional 17 (14.65%) in 1-2 weeks, totalling 31 (26.72%) within 3 weeks. Five eyes (4.31%) completely healed at 5 week; three eyes (2.59%) had subsequent healing of epithelial defect at 6 week; 56 eyes completely healed within one month, and the remaining eight eyes healed within 1.5 month.Conclusion: Using serum therapy, it was managed to reduce time of healing from eleven weeks, which were necessary just couple years ago (before 2010) to four (maximum six) weeks to complete healing which are necessary today.

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Topical insulin for refractory persistent corneal epithelial defects

European Journal of Ophthalmology ◽

10.1177/1120672120958307 ◽

2020 ◽

pp. 112067212095830

Author(s):

David Diaz-Valle ◽

Barbara Burgos-Blasco ◽

Jose A Gegundez-Fernandez ◽

Sara Garcia-Caride ◽

Virginia Puebla-Garcia ◽

...

Keyword(s):

Primary Outcome ◽

Healing Time ◽

Bullous Keratopathy ◽

Eye Drops ◽

Ocular Surgery ◽

Corneal Epithelial ◽

Area Reduction ◽

Mean Time ◽

Persistent Epithelial Defects

Purpose: To evaluate insulin eye drops for persistent epithelial defects (PEDs) that are refractory to usual treatment in clinical practice and to analyze how it may improve epithelization. Methods: A prospective non-randomized hospital-based study was performed. Patients with PEDs that were refractory to conventional treatment were treated with insulin eye drops four times a day. Patients’ demographics, PED etiology, concomitant treatments, and comorbidities were reviewed. The rate of PED closure and epithelial healing time were considered the primary outcome measures. Results: 21 patients were treated with insulin drops (12 females and 9 males; mean age 72.2 years). Mean PED area before treatment was 17.6 ± 16.5 mm2 (median 13.2; range 3.9–70.6). PED comorbidities included seven eyes with infectious keratitis (33%), five eyes with calcium keratopathy (24%), ocular surgery on three eyes (14%), three eyes with lagophthalmos (14%), two eyes with bullous keratopathy (10%), and one patient with herpetic eye disease (5%). The eyes of 17 patients (81%) with refractory PEDs had reepithelized and four patients (19%) had still presented an epithelial defect by the end of the study follow-up period, although it had decreased in size. In patients where PED closure was achieved, mean time until reepithelization was 34.8 ± 29.9 days (median 23; range 7–114). In the remaining patients, a mean area reduction of 91.5% was achieved for the PEDs. Conclusion: Topical insulin can promote and accelerate corneal reepithelization of refractory PEDs. It also offers many other advantages, including excellent tolerance, availability, and cost-effectiveness.

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Applications of Autologous Serum Eye Drops in Aniridic Keratopathy

European Ophthalmic Review ◽

10.17925/eor.2009.03.01.51 ◽

2009 ◽

Vol 03 (01) ◽

pp. 51 ◽

Cited By ~ 2

Author(s):

José Santiago López-García ◽

Keyword(s):

Growth Factors ◽

Tear Film ◽

Biomechanical Properties ◽

Autologous Serum ◽

Eye Drops ◽

Impression Cytology ◽

Film Instability ◽

Congenital Aniridia ◽

Corneal Cells ◽

Serum Eye Drops

Aniridia is an uncommon congenital bilateral disease that involves the cornea, anterior chamber, lens, retina and optic nerve. Corneal changes in aniridic keratopathy include recurrent erosions of corneal epithelium, tear film instability, chronic pain, corneal vascularisation, dry eye, progressive corneal opacification and blindness. The autologous serum contains a variety of growth factors, vitamins and immunoglobulins, some of which are in higher concentrations than in natural tears. The growth factors and protein found in the serum may help the proliferation, migration and adhesion of epithelial corneal cells. They are by nature non-allergenic and their biochemical and biomechanical properties are similar to those of normal tears. The ocular surface, including corneal impression cytology and tear film evaluation, of patients with congenital aniridia was studied prior to and after treatment with autologous serum eye drops.

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Autologous Serum Eye Drops for Treating Persistent Corneal Epithelial Defect After Vitreoretinal Surgery

Cornea ◽

10.1097/ico.0b013e3181786a68 ◽

2008 ◽

Vol 27 (9) ◽

pp. 1097 ◽

Cited By ~ 4

Author(s):

Wei-Cheng Huang ◽

Chun-Chi Chiang ◽

Yi-Yu Tsai

Keyword(s):

Vitreoretinal Surgery ◽

Autologous Serum ◽

Eye Drops ◽

Epithelial Defect ◽

Corneal Epithelial ◽

Corneal Epithelial Defect ◽

Serum Eye Drops

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Why Chain Length of Hyaluronan in Eye Drops Matters

Diagnostics ◽

10.3390/diagnostics10080511 ◽

2020 ◽

Vol 10 (8) ◽

pp. 511 ◽

Cited By ~ 2

Author(s):

Wolfgang G.K. Müller-Lierheim

Keyword(s):

Molecular Weight ◽

Epithelial Cells ◽

Chain Length ◽

Ocular Surface ◽

Clinical Performance ◽

Average Molecular Weight ◽

Tear Film ◽

Eye Drops ◽

Zero Shear Viscosity ◽

Corneal Epithelial

The chain length of hyaluronan (HA) determines its physical as well as its physiological properties. Results of clinical research on HA eye drops are not comparable without this parameter. In this article methods for the assessment of the average molecular weight of HA in eye drops and a terminology for molecular weight ranges are proposed. The classification of HA eye drops according to their zero shear viscosity and viscosity at 1000 s−1 shear rate is presented. Based on the gradient of mucin MUC5AC concentration within the mucoaqueous layer of the tear film a hypothesis on the consequences of this gradient on the rheological properties of the tear film is provided. The mucoadhesive properties of HA and their dependence on chain length are explained. The ability of HA to bind to receptors on the ocular epithelial cells, and in particular the potential consequences of the interaction between HA and the receptor HARE, responsible for HA endocytosis by corneal epithelial cells is discussed. The physiological function of HA in the framework of ocular surface homeostasis and wound healing are outlined, and the influence of the chain length of HA on the clinical performance of HA eye drops is illustrated. The use of very high molecular weight HA (hylan A) eye drops as drug vehicle for the next generation of ophthalmic drugs with minimized side effects is proposed and its advantages elucidated. Consequences of the diagnosis and treatment of ocular surface disease are discussed.

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