Autologous serum eye drops diluted with 0.5% methylcellulose and 0.9% saline solution: a clinical comparative study

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Regenerative Medicine

Background:

• Severe dry eye disease (DED) and persistent epithelial defects often require advanced therapies.
• Autologous serum (AS) eye drops are a recognized treatment for refractory DED.
• The optimal diluent for AS eye drops remains an area of investigation.

Purpose of the Study:

• To compare the efficacy of autologous serum 20% eye drops diluted with 0.9% saline versus 0.5% methylcellulose.
• To evaluate subjective symptom improvement and objective clinical signs in patients with severe DED.

Main Methods:

• A longitudinal prospective study involving 23 patients (42 eyes) with refractory DED.
• Patients used AS 20% with methylcellulose and subsequently switched to AS 20% diluted in 0.9% saline.
• Evaluations included the Salisbury Eye Evaluation Questionnaire, slit-lamp examination, tear breakup time, corneal staining, Schirmer's test, rose Bengal test, and tear meniscus height.

Main Results:

• No significant differences were observed in subjective symptoms or most objective measures (tear breakup time, staining, rose Bengal test, tear meniscus height) between diluents.
• Schirmer's test scores significantly worsened at 30 and 90 days when using saline diluent (p=0.008).
• No complications or adverse effects were reported with either formulation.

Conclusions:

• Autologous serum 20% is a successful treatment for severe, refractory DED.
• Autologous serum diluted in 0.9% saline demonstrates comparable efficacy to methylcellulose formulation.
• The saline formulation offers a more cost-effective alternative for AS eye drops.