Postgraduate Program in Medicine: Surgical Sciences, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Arq Bras Oftalmol. 2023 Apr 17;87(5):e20220064. doi: 10.5935/0004-2749.2022-0064. eCollection 2023.
This clinical study compared autologous serum eye drops diluted with 0.5% methylcellulose and 0.9% saline solution. The subjective criteria for symptom improvement and the objective clinical criteria for response to therapy were evaluated.
This longitudinal prospective study enrolled 23 patients (42 eyes) with persistent epithelial defects or severe dry eye disease refractory to conventional therapy who had been using autologous serum 20% prepared with methylcellulose for > 6 months and started on autologous serum diluted in 0.9% saline solution. The control and intervention groups consisted of the same patients under alternate treatments. The subjective criteria for symptom relief were evaluated using the Salisbury Eye Evaluation Questionnaire. The objective clinical criteria were evaluated through a slit-lamp examination of the ocular surface, tear breakup time, corneal fluorescein staining, Schirmer's test, rose Bengal test, and tear meniscus height. These criteria were evaluated before the diluent was changed and after 30, 90, and 180 days.
In total, 42 eyes were analyzed before and after 6 months using autologous serum diluted with 0.9% saline. No significant differences were found in the subjective criteria, tear breakup time, tear meniscus, corneal fluorescein staining, or rose Bengal test. Schirmer's test scores significantly worsened at 30 and 90 days (p=0.008). No complications or adverse effects were observed.
This study reinforces the use of autologous serum 20% as a successful treatment for severe dry eye disease resistant to conventional therapy. Autologous serum in 0.9% saline was not inferior to the methylcellulose formulation and is much more cost-effective.
本临床研究比较了用 0.5%甲基纤维素和 0.9%生理盐水稀释的自体血清滴眼液。评估了症状改善的主观标准和治疗反应的客观临床标准。
这项纵向前瞻性研究纳入了 23 名（42 只眼）持续性上皮缺损或对常规治疗有反应的严重干眼患者，他们使用了 0.5%甲基纤维素配制的 20%自体血清超过 6 个月，并开始使用 0.9%生理盐水稀释的自体血清。对照组和干预组由交替治疗的相同患者组成。使用 Salisbury 眼评价问卷评估症状缓解的主观标准。通过裂隙灯检查眼表面、泪膜破裂时间、角膜荧光素染色、泪液分泌试验、虎红试验和泪膜高度来评估客观临床标准。这些标准在改变稀释剂之前和 30、90 和 180 天后进行评估。
共有 42 只眼在使用 0.9%生理盐水稀释的自体血清前后进行了 6 个月的分析。在主观标准、泪膜破裂时间、泪膜高度、角膜荧光素染色或虎红试验中，均未发现显著差异。Schirmer 试验评分在 30 和 90 天时显著恶化（p=0.008）。未观察到并发症或不良反应。
本研究再次证实了 20%自体血清作为一种成功的治疗严重干眼病的方法，这种疾病对常规治疗有抵抗力。0.9%生理盐水的自体血清并不逊于甲基纤维素配方，而且更具成本效益。
