Aplicaciones del suero autólogo en oftalmología

Abstract

RESUMENObjetivo: Establecer un protocolo razonado para la preparación y manejo de la terapia con suero autó-logo en la práctica oftalmológica. Métodos: Revisión bibliográfica y experiencia personal. Resultados: La utilización de suero autólogo en colirio ha sido referida por muchos autores como una nueva forma de terapia en el manejo de enfermedades de la superficie ocular. El suero autólogo presenta unas propiedades mecánicas y bioquímicas similares a las de la lágrima, y como ésta contiene componentes como la fibronectina, vitamina A y factores de crecimiento que tienen un efecto epiteliotrófico sobre las células epiteliales de la superficie ocular. Conclusiones: Los distintos estudios publicados muestran una importante variabilidad tanto en la eficacia de esta terapia como en la metodología de preparación y aplicación.Palabras clave: Suero autólogo, superficie ocular, ojo seco, epitelio corneal, citología de impresión. REVISIÓN ABSTRACTObjective: To establish a protocol for the use of autologous serum in the ophthalmic practice. Methods: Personal experience and a literature review. Results: The use of autologous serum, in eye drop form, has been reported as a new treatment for several ocular surfaces diseases. These products have biomechanical and biochemical properties similar to normal tears. They contain components such as fibronectin, vitamin A and growth factors that have an epitheliotrophic effect on the ocular surface epithelial cells. Conclusions:The clinical studies performed showed a variable efficacy, with the preparative process and use of the autologous serum eye drops varying considerably between different studies (Arch Soc Esp Oftalmol 2007; 82: 9-20).

Plasma Rich in Growth Factors as a Therapeutic Agent for Persistent Corneal Epithelial Defects

“…Despite having various causes, these defects share in common the incapacity of the cornea to close its damaged epithelium and thus constitute an important therapeutic challenge in daily clinical practice. 1,2,7,8 The forms of PED with worse prognosis have been reported to be those associated with severe dry eye and neurotrophic ulcers. 1 In the case of dry eye, the lack of tears results in growth factor deprivation; in the case of neurotrophic ulcer, factors necessary for neural metabolism, such as substance P and NGF, are absent.…”

“…Our study was approved by the Ethics Committee of the Instituto Clínico-Quirúrgico de Oftalmología, and the principles of the Helsinki Declaration were complied with. The etiopathology of the epithelial defects was varied: neurotrophic ulcers (9; 6 nonherpetic and 3 herpetic), iatrogenic (6 cases; after ocular surgery), secondary to chemical burn (3), and secondary to severe dry eye (2).…”

“…1,3 Other causes include burns because of chemical agents, immunological alterations, dystrophies of the epithelium and basal membrane, metabolic alterations, iatrogenia, trauma, and infections. [1][2][3] Not infrequently, PEDs do not respond to the application of conventional treatments such as artificial tears, therapeutic contact lenses, antiinflammatory agents, oral antibiotics, inhibitors of collagenolytic enzymes, or tarsorrhaphy. Resistant PEDs continue to degenerate, in many cases toward progressive stromal lysis and subsequent perforation; therefore new therapeutic alternatives are urgently being sought.…”

“…1,2 The etiopathology of PED can be very variable, but the 2 principal causes are alterations in the tear surface and neurogenic dysfunctions. 1,3 Other causes include burns because of chemical agents, immunological alterations, dystrophies of the epithelium and basal membrane, metabolic alterations, iatrogenia, trauma, and infections.…”

“…Among the topically applied natural preparations, autologous serum has been used in recent years for the treatment of PED and dry eye with satisfactory results in most cases. 1,2 More recently, a novel treatment has been proposed, consisting of plasma rich in growth factors (PRGF). [4][5][6] This treatment involves the application of autologous platelet protein extracts, which are rich in growth factors.…”