Do you have dry eyes?
If you suffer from dry eye syndrome, you may already be familiar with the frustration of trying to manage your symptoms. Because you are not making enough tears.
Unfortunately, many people fail to obtain symptom relief despite trying many artificial tears, ointments, eyelid hygiene regimens, collagen tear duct plugs (punctal plugs), or laser treatment options of the lacrimal glands to boost their natural tear production.
If you are one of those who have failed to find long-lasting relief, autologous serum eye drops (ASED) may be a good option.
What is Autologous Serum Drop.
The use of autologous serum eye drops dates back to 1975, when they were first used to treat chemical burns of the eye. ASEDs are made from serum. The serum is a component of your blood. The autologous serum drop is made by combining serum with sterile saline or eye drops. This eye drop is then a lubricating fluid rich in nutrients and growth factors.
People with severe dry eyes are maybe missing these components. The term autologous means that it comes from your own body. This is particularly useful when the eye doctor(s) suspect cornea damage from severe dry eyes.
The autologous serum has been used as an eye drop to treat severe chronic dry eyes for a long time. We will discuss some of the pros, cons, and precautions of using autologous serum drops.
The autologous serum is prepared from one’s own blood, which is more compatible with one’s own tear. During the preparation, blood is spun in a centrifuge to remove all cells.
What lies on top is then removed to be diluted with saline or eye drop. It also contains many of the proteins, growth factors that one needs to promote healthy cornea. The preparation is often done in a compounding pharmacy and stored in bottles for application.
ASEDs are highly effective, well-tolerated, and have ingredients that artificial tears just can’t replicate. However, ASED’s can promote healthy growth and healing of the ocular surface (called the cornea). Some of the ingredients in ASEDs are found in natural tears. But are not available in artificial tears include antibodies, albumin, Vitamin A, and specific growth factors essential for healthy eyes known as epidermal growth factors.
Note that ASEDs are not tear substitutes and are often used in conjunction with other treatment modalities such as artificial tears, DELIT laser, punctal plugs, in patients requiring more advanced eye treatment.
Bacterial Contamination of Autologous Serum Drops
Since it is derived from the biological fluid (blood), autologous serum naturally has a high protein content, potentially creating a media for bacteria growth. While a preservative could be added, its toxic effects could cause problems. Non-compliance can often lead to eye infections.
A 2013 study cultured bottles of autologous serum eye drops from 21 dry eye patients found that close to 4% were positive for bacterial or fungal contamination before the bottles were opened. Therefore, the use of specialty sterilizing containers has been studied.
When adapted mechanical filters are used, the contamination is significantly reduced. Consider consulting with your compounding pharmacy about ways to improve sterilization in the bottles of autologous serum eye drops.
Plasma Rich Serum Drops vs. Traditional Autologous Serums Drops
The difference between the two methods has to do with the centrifuge speed. The plasma rich method uses a gentle spin and retains the platelets in the serum. The plasma is then diluted with sterile saline or eye drops to make the final preparation.
The traditional autologous serum contains growth factors, neuropeptides, and vitamins common in the tear film. It can also include proinflammatory cytokines and immunoglobulins.
Plasma has enriched platelet concentration (and with red and white blood cells removed) can also provide all of these beneficial growth factors and neurotrophic peptides but without the proinflammatory molecules. Only a few preclinical and clinical studies have been performed to date, all with positive findings.
Why Do Autologous Serum Drops Fail?
Using owns own blood is the closest to your own biological fluid as possible. However, there are more than 300 components of one’s own natural tears that are just not the same.
Another important factor is- frequent use of eye drops make eyes drier.
Drops wash away your own natural lubricants, making eyes drier.
While several theories have been floated as to why ASEDs failed to improve significantly in dry eye relief. The truth is that no one is exactly sure how the drops work. It is possible that eye drops made from your own blood contain a lot of albumins (a natural protein also found in eggs), which creates a higher quality, protective tear film for the corneal epithelial cells (surface cells).
In addition to improving the quality of a patient’s tear film, we’ve observed that using the serum for the eyes helps enhance the health of the delicate nerves on the eye’s surface. Autologous serums are used because artificial tears have their limitations. The autologous serum can be used to improve the healing potential of the ocular surface before and after certain surgeries such as corneal transplants and vitrectomies.
A Successful Alternative to Serum Drops- Oral Dry Eye Treatment
This is the reason why TheraLife developed oral dry eye treatment – to revive and restore your own tear production cells from inside out.
This is particularly important when eye drops no longer work.
Conclusions
The use of autologous eye drops for people with severe dry eyes can be life-changing. There is currently no standardized protocol for being prepared, stored, dosed, or discarded. Education and compliance are a must for successful therapy.
References
1. Thanathanee O, Phanphruk W, Anutarapongpan O, et al. Contamination risk of 100% autologous serum eye drops in managing ocular surface diseases.Cornea. 2012;32(8):1116-9.
- Lopez-Garcia J, Garcia-Lozano I. Use of containers with sterilizing filter in autologous serum eyedrops. Ophthalmol. 2012;119(11):2225-30.
- Anitua E, Muruzabal F, Tayebba A, et al. Autologous serum and plasma rich in growth factors in ophthalmology: preclinical and clinical studies. Acta Ophthalmol.2015;93:e605-14.
- http://www.medscape.com/viewarticle/836825-Medscape
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1772389/-NIH
Great article. I tried ASEDs. They were not effective and expensive. Just like the artificial tears. I had to increase the frequency of dosing and discontinued them after going through an entire syringe in a day!
Christian – Thank you for your feedback. Glad TheraLife Eye is working for you instead. Happy New Year
Dr. Lily C. Yang
TheralIfe Inc.