Usage of Autologous Serum Eye Drops

Tears have antimicrobial, nourishing, mechanical, and optical properties and contain components such as growth factors, fibronectin and vitamins to support proliferation, migration and differentiation of corneal and conjunctival epithelial cells. Lack of these epitheliotrophic factors, as in dry eye, can result in severe ocular surface disorders such as persistent epithelial defects. Recently, the use of autologous serum in the form of eye drops has been reported as a new treatment for severe ocular surface disorders. Serum eye drops may be produced as an unpreserved blood preparation. They are by nature non-allergenic and their biomechanical and biochemical properties are similar to normal tears. In vitro cell culture experiments showed that corneal epithelial cell morphology and function are better maintained by serum than by pharmaceutical tear substitutes. Clinical cohort studies have reported its successful use for severe dry eyes and persistent epithelial defects. However, the protocols to prepare and use autologous serum eye drops varied considerably between the studies. In addition to different biochemical properties, protocol variations may also influence the epitheliotrophic effect of the product. Before establishing the definitive role of serum eye drops in the management of severe ocular surface diseases in a large randomized controlled trial, this has to be evaluated in more detail. Based upon the literature reviewed here, two preliminary standard operating procedures for the preparation of serum eye drops are proposed.