Collin County Living Well Magazine July/August 2018

AUTOLOGOUS EYE DROPS FOR DRY EYE By Donna S. Barsky, PharmD D ry eye can be a severe problem for many people and can be caused by several things, including cataract surgery, Lasik procedures, and just re- duction in tear production. can be a major positive in corneal disorders. In fact, they are by nature non-allergenic and their biomechanical and biochemical properties are like normal tears. The physician can order these for patients if they have tried Our tears have antimicrobial, nourishing, mechanical, and other commercial medications and found no relief. First, the optical properties. They contain proteins, growth factors, physician can order a blood draw for the serum, as well fibronectin, and vitamins to support proliferation, migra- as a prescription for the percent that the physician deems tion, and differentiation of the cor- necessary for good results. neal and conjunctival epithelium. A lack of these epitheliotropic (repair- Most labs will not let the blood sit for EYE DROPS MADE FROM ing) factors—for example, dry eye two hours to clot; therefore, they must AUTOLOGOUS SERUM can result in severe ocular surface spin in a centrifuge for a minimum of disorders such as persistent epithelial 30 minutes. For most labs, that would ARE A NEW THERAPEUTIC defects. require spinning through two cycles APPROACH FOR since most of the centrifuge units are There are many commercial eye calibrated to a 15-minute cycle. After OCULAR SURFACE drops available in today’s market; spinning, the vials need to be packed however, in-vitro cell culture experi- in a cooler and brought to the pharma- . ments showed that corneal epitheli- cy for processing. For most individu- al cell morphology and function are als, a 100ml blood draw will deliver better maintained by serum than by pharmaceutical tear 30-35ml of serum for use in eye drops. If there are any substitutes. particles of blood floating in the vial, the vial cannot be used because one drop of blood in an eye drop can be Eye drops made from autologous serum are a new thera- detrimental to the cornea, especially if the patient wears peutic approach for ocular surface disorders, such as per- contacts. sistent epithelial defects or severe dry eyes intractable to conventional therapy. The presence of growth factors and On another note, it is amazing to see, when the serum ar- vitamins in serum eye drops might also have a true epith- rives, how clear or cloudy the fluid can be. This all depends eliotropic potential for the ocular surface. on the total cholesterol that a patient carries. The higher the cholesterol count, the cloudier the serum becomes. Choles- The biggest contraindication (reason to not use) is a posi- terol in serum is like the cream floating on top of the whey tive serology for HIV, Syphilis, Hepatitis B (HBV), and Hep- at the dairy. atitis C (HCV). For all others, the use of one’s own serum DISORDERS 18 COLLIN COUNTY Living Well Magazine | JULY/AUGUST 2018

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