| Past Issue | Volume 8, Number 6, December 2006 | | Treatment of Persistent Corneal Epithelial Defect with Autologous Serum |
Hossein Movahedan, Vahid Ghassemifar
Ophthalmology Department, Shiraz University of Medical Sciences, Shiraz, Iran
Aim: To determine the efficacy and safety of topical autologous serum as an alternative treatment for persistent corneal epithelial defect and non-healing corneal ulcer.
Patients and Methods: Twenty eyes with clinical evidence of persistent corneal epithelial defect of at least 2 weeks’ duration that failed to heal with conventional treatment were evaluated. Relevant patient details were recorded, including the cause and duration of persistent corneal epithelial defect, previous treatments, and past medical and ocular history. Slit-lamp examination established the size and location of persistent corneal epithelial defect and also the status of associated inflammation and neovascularisation, dry eye, and corneal sensation. One eye was excluded due to complete healing during this period. Treatment consisted of 20% autologous serum diluted in preservative-containing artificial tears applied 4 to 6 times per day for up to 4 weeks.
Results: The mean duration of persistent corneal epithelial defect prior to treatment was 52.2 days. Following the use of serum eyedrops, healing occurred in 8 eyes (40%) within ≤ 2 weeks and in 6 eyes (30%) within 2 to 4 weeks. All patients reported subjective improvement. Healing occurred in all 8 eyes with corneal anaesthesia but not in 3 eyes with underlying thermal burns. Healing was more rapid in persistent corneal epithelial defects with an initial size of ≤ 2.5 mm or eyes with postoperative persistent corneal epithelial defect. Long-term follow-up of 10 patients confirmed ocular surface stability in each patient. No major ocular or systemic side effects were observed.
Conclusion: Topical administration of preservative-containing autologous serum was found to be an effective and safe therapy for persistent corneal epithelial defect and can be used as an alternative to more aggressive surgical management.
Key words: Corneal diseases, Corneal epithelium, Eyedrops, Serum, Treatment outcome
Asian J Ophthalmol 2006; 8:236-241.
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