Denton County Living Well Magazine July/August 2018 | Page 42
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.
Our tears have antimicrobial, nourishing, mechanical, and
optical properties. They contain proteins, growth factors, fi-
bronectin, and vitamins to support proliferation, migration,
and differentiation of the corneal and conjunctival epithe-
lium. A lack of these epitheliotropic (repairing) factors—for
example, dry eye can result in severe ocular surface disor-
ders such as persistent epithelial defects.
There are many commercial eye drops available in today’s
market; however, in-vitro cell culture experiments showed
that corneal epithelial cell morphology and function are
better maintained by serum than by pharmaceutical tear
substitutes.
Eye drops made from autologous serum are a new thera-
peutic approach for ocular surface disorders, such as per-
sistent epithelial defects or severe dry eyes intractable to
conventional therapy. The presence of growth factors and
vitamins in serum eye drops might also have a true epith-
eliotropic potential for the ocular surface.
The biggest contraindication (reason to not use) is a posi-
tive serology for HIV, Syphilis, Hepatitis B (HBV), and Hep-
atitis C (HCV). For all others, the use of one’s own serum
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
other commercial medications and found no relief. First, the
physician can order a blood draw for the serum, as well
as a prescription for the percent that the physician deems
necessary for good results.
Most labs will not let the blood sit for two hours to clot;
therefore, they must spin in a centrifuge for a minimum
of 30 minutes. For most labs, that would require spinning
through two cycles since most of the centrifuge units are
calibrated to a 15-minute cycle. After spinning, the vials
need to be packed in a cooler and brought to the phar-
macy for processing. For most individuals, a 100ml blood
draw will deliver 30-35ml of serum for use in eye drops. If
there are any particles of blood floating in the vial, the vial
cannot be used because one drop of blood in an eye drop
can be detrimental to the cornea, especially if the patient
wears contacts.
On another note, it is amazing to see, when the serum ar-
rives, how clear or cloudy the fluid can be. This all depends
on the total cholesterol that a patient carries. The higher the
cholesterol count, the cloudier the serum becomes. Choles-
terol in serum is like the cream floating on top of the whey
at the dairy.
When the pharmacy receives the vials, the serum is im-
mediately drawn from the vials. These drops must be pro-
cessed within 48 hours to be viable. Also, if we leave
the serum in the vials, there is a possibility that some of
the blood that has been separated may contaminate the
serum if left too long.
When the serum has been prepared, it is dispensed into
small eye-dropper vials for usage and after seven to 10
days, discarded. The remainder of the product is kept in
the freezer until needed by the patient. The pharmacy will
only process enough serum to last the patient up to six
months, any longer may put the patient at risk of contami-
nation or degradation of proteins in the serum and thus
reduction of healing.
If dry eyes have been a problem with you or anyone you know, please contact us at Texas Star
Pharmacy, 3033 W. Parker Rd., STE 100, Plano, TX, 75023. Or call us at 972-519-8475,
EXT 3 for any information about autologous eye drops.
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DENTON COUNTY Living Well Magazine | JULY/AUGUST 2018