Treating severe dry eye syndromes with autologous serum

Background: Dry eye syndrome with tear deficiency can be improved with artificial tears, which can be associated with topical anti-inflammatory agents. Autologous serum can provide the ocular surface with beneficial growth factors and vitamins. Patients and methods: Twenty-one patients suffering from severe dry eye due to Sjogren's syndrome were treated with 20% autologous serum for 2 months. The Schirmer 1 test, breakup time, and fluorescein and lissamine green stainings were performed before and after treatment. Subjective complaints such as burning, foreign body sensation, dryness and photophobia were assessed by a questionnaire as well as a face score reflecting the current condition of patients' eyes. Results: Lissamine green and fluorescein scores improved significantly as well as subjective symptoms of burning, foreign body sensation and dryness (p<0.05). The face score was significantly improved. Bacterial culture of serum delivered to the patients all remained negative. Discussion: Autologous serum provides growth factors and vitamins that are useful for an altered ocular surface due to Sjogren's disease. However, some problems still remain: risk of contamination, arbitrary dilution of autologous serum, and a current lack of regulations for use of autologous serum. A close collaboration between ophthalmologists and the Etablissement Francais du Sang (French Blood Bank) is mandatory because autologous serum should be considered as a useful tool to treat severe ocular surface disorders. Conclusion: The use of autologous serum improved symptoms and objective signs caused by severe Sjogren's syndrome. Currently, a lack of clear regulations prevents its widespread use in severe ocular surface disorders.