Autologous serum eye‐drops and enhanced epithelial healing time after photorefractive keratectomy

Abstract

Background: The aim of the study is to test whether use of autologous serum eye-drops can provide earlier epithelial healing following the application of photorefractive keratectomy. Method: Sixty patients (60 eyes) underwent photorefractive keratectomy for myopia. Thirty eyes received autologous serum drops (Study group) while 30 eyes received conventional artificial tears (Control group) after photorefractive keratectomy. An 8 mm epithelial opening was prepared with the application of 18 per cent alcohol for 20 seconds. Photorefractive keratectomy was performed using ESIRIS excimer laser (SCHWIND, Kleinostheim, Germany) with an optic zone of 6.5 mm. Total duration of epithelial healing was monitored as the main outcome measure. The comparisons were done with chi-square test and independent samples t-test. Statistical significance was considered at p < 0.05. Results: Preoperative myopic spherical refraction and ablation depths were similar in the study and control groups. The mean duration for epithelial healing was about one day shorter in the eyes receiving autologous serum compared to the eyes receiving conventional treatment (2.2 AE 0.25 days versus 3 AE 0 days, p = 0.001). All eyes achieved 6/7.5 or better uncorrected visual acuity in six months. In both groups, more than 90 per cent of eyes were within AE0.50 D of emmetropia in 12 months. No significant difference was noted for the incidence of +1 haze. Conclusion: Use of autologous serum drops reduces epithelial healing duration following surface ablation for two days.

Plasma Rich in Growth Factors (PRGF) in Transepithelial Photorefractive Keratectomy (TPRK)

“…The nerve growth factor induces an injured neuron’s function restoration that helps in corneal nerve regeneration [ 31 ]. However, in the results obtained by Akcam et al [ 17 ], the AS reduced pain score and reepithelialization time compared to an artificial tears group. In their study, surgery was alcohol-assisted PRK.…”

“…Recently, PRGF has been studied in the dry eye disease (DED) assessment and after laser-assisted in-situ keratomileusis (LASIK) [ 12 ], as an accelerator of the healing process in PRK [ 13 ] in mice [ 14 ] and as a regenerator of the corneal nerves after LASIK [ 15 ]. Other studies have analyzed autologous serum effect on re-epithelialization time in laser-assisted subepithelial keratectomy (LASEK) [ 16 ] and PRK [ 17 ].…”

Effect of 3% topical trehalose on the rate of corneal re-epithelialization in patients undergoing photorefractive keratectomy

“…Another randomized, double-masked and controlled parallel-group study 15 evaluating tear film thickness after treatment with artificial tears in patients with moderate dry eye disease, showed that a single instillation of trehalose (30 mg/mL) and sodium hyaluronate (1.5 mg/mL) increased the thickness of the tear film in patients with dry eye disease. The data also indicate a longer corneal retention of eye drops in the eyes that received trehalose.…”

“…The recovery process, as well as its main symptoms, are directly related to the epithelialization process, which takes place after 3-7 days on average; once the corneal epithelium has completely covered the surface of the cornea, symptoms and visual quality improve dramatically. Symptoms that occur in the corneal epithelialization phase after PRK include pain, foreign body sensation, photophobia, and blurred vision [15][16][17][18][19][20][21] .…”

Emerging Approaches for Ocular Surface Regeneration

“…Platelet-derived preparations and autologous/allogeneic serum eye-drops (ASE) are used therapeutically for restoring the disturbed micro-environment of the ocular surface. They are rich in growth factors, cytokines, vitamins and minerals which are required for normal corneal epithelial homeostasis and can stimulate proliferation, differentiation, and migration on the ocular surface [79]. Autologous serum eye-drops are similar to human tears regarding components such as EGF, TGF-β, fibronectin, vitamin A and other common cytokines [73][74][75].…”