The American Academy of Ophthalmology recently reported that, although autologous serum-based tears may be safe and effective in the treatment of severe dry eye and persistent corneal epithelial defect, the lack of controlled trials and variability in study protocols continues to hamper their widespread acceptance.

Researchers recently conducted a literature search and found only 13 studies that met the inclusion criteria. After assigning each study a quality-of-evidence rating, they had eight with a level II rating and five with a level III. Ten studies evaluated autologous serum-based eye drops for severe dry eye disease and four evaluated them for persistent epithelial defect.

The investigators found several of the studies show good effectiveness with some improvement in signs, symptoms or both. They note that eight of the 10 dry eye studies reported improved symptoms for severe dry eye disease and all reported improvement in at least one clinical sign. For persistent epithelial defect, all studies show improvement, with three of the four demonstrating an improvement rate of greater than 90%.

“The limited accessibility and substantial cost of autologous serum-based eye drops create challenges for implementation, and, therefore, result in reserving their use either for more severe cases or for cases that have not improved using more readily available and less costly therapies,” the study authors concluded in their paper.

As this treatment seems to be a reasonable option in refractory cases of dry eye or non-healing epithelial defects, the researchers advise following the proper care and use instructions to minimize microbial growth contamination; serum-based solutions are essentially “growth media,” they explain in the report.

Shtein RM, Shen JF, Kuo AN, et al. Autologous serum-based eye drops for treatment of ocular surface disease. Ophthalmology. September 24, 2019. [Epub ahead of print].