I met my first patient who has used Albumin drops for dry eyes.

He came in because he believes a recent new surge of styes and chalazia were caused by his use of albumin drops. He had used a compounding pharmacy in Michigan. Initially, he asked if they could send him autologous serum but in a series of conversations, he realized it was albumin they would be selling him for about $200 for a month.

Human serum albumin is a small protein synthesized by the liver. It is found in the blood (circulatory system) and is the most abundant plasma protein in our body. It has many crucial roles: regulates inflammation; binds/transports fatty acids, hormones, metabolites, endogenous ligands, and drugs; maintenance of colloid osmotic blood pressures; preserves of blood pH; binds nitric oxide,

The idea behind albumin started with a couple of papers like the one below.

Autologous serum contains many proteins, such as interleukins, cytokines, lactoferrin, and immunoglobulins. But serum also has a substantial quantity of other non-defined proteins in the pre-albumin and albumin fractions.

In study below, patients with Sjögren’s syndrome used albumin drops and showed statistically significant improvement in fluorescein and rose bengal scores, but not in tear break up time and subjective symptoms. No adverse effects of albumin were observed during the study. The use of albumin as a protein supplement in artificial tear solutions is a viable approach in the treatment of ocular surface disorders associated with tear deficiency.

Recombinant HSA (rHSA) has been successfully produced using a methylotrophic yeast, Pichia pastoris but I could not find a comparison of Human Albumin drops versus recombinant ones.

Recombinant albumin drops (5% or 10% recombinant albumin in some studies) can be obtained from Hyalein Mini, Santen Pharmaceuticals, Osaka, Japan or other compounding pharmacies.

Most studies and doctors have noted that Autologous Serum is prefereable to Albumin drops as AS has grown factos, lysozymes, cytokines which help heal ocular suface tissue.

Still there are some patients who cannot have their blood drawn or have poor veins: they may benefit from Albumin drops.

I could not find a case report of a chalazion after the use of Albumin drops, but this might be the first report of an association.

SLC

References

. 2003 Oct; 87(10): 1279–1283.

Albumin as a tear supplement in the treatment of severe dry eye

S Shimmura,¹ R Ueno,² Y Matsumoto,¹ E Goto,¹ A Higuchi,¹ J Shimazaki,¹ and K Tsubota¹

Author information Article notes Copyright and License information Disclaimer

Abstract

Aim: To determine the efficacy of using albumin tear supplements in the treatment of ocular surface disorders as a substitute for serum eye drops.

Methods: The effects of albumin on the viability of serum deprived conjunctival cell were observed in vitro. The ability for albumin to compensate for serum was demonstrated by measuring the activity of the apoptosis related enzyme, caspase-3. In an animal study, corneal erosions were inflicted in 40 Japanese white rabbits. Rabbits were treated with 5% or 10% solutions of human albumin, and the decrease in epithelial defect size was compared with saline control and 0.3% sodium hyaluronate. A clinical case series trial of 5% albumin drops was conducted in nine patients with Sjögren’s syndrome with severe dry eye.

Results: The addition of albumin to serum deprived conjunctival cells inhibited caspase activity and increased cell viability, showing that albumin can compensate for some of the physiological properties of serum. Corneal erosions in rabbits healed significantly faster (p<0.05) in eyes treated with 10% albumin compared with control and sodium hyaluronate. Patients with Sjögren’s syndrome used albumin drops showed statistically significant improvement in fluorescein and rose bengal scores, but not in tear break up time and subjective symptoms. No adverse effects of albumin were observed during the study.

Conclusions: The use of albumin as a protein supplement in artificial tear solutions is a viable approach in the treatment of ocular surface disorders associated with tear deficiency.

2.

. 2015 Oct; 22(5): e357–e363.

doi: 10.3747/co.22.2620

PMCID: PMC4608409

PMID: 26628876

Human albumin eye drops as a therapeutic option for the management of keratoconjunctivitis sicca secondary to chronic graft-versus-host disease after stem-cell allografting

J.T. Seki, RPh BSc(Phm) PharmD,^*^‡^† N. Sakurai, BSc(Phm) MSc,^* S. Moldenhauer, PharmD,^*^† J. Dam, RPhT,^* E.G. Atenafu, MSc,^* P.M. Yip, PhD,^§ T. Mazzulli, MD,^‡^‖ T. Henderson, BSc,^# J. Pendergrast, BA BSc(Med) MD,^§ C. Cserti, HBSc MD,^§ J.P. Velazquez, MD,^* R. Simpson, MD,^* G. Felluga, CPhT,^* H.A. Messner, MD PhD,^* and J.H. Lipton, MD PhD^*

Background

Keratoconjunctivitis sicca from chronic graft-versus-host disease (cgvhd) after allogeneic stem cell transplantation is common, leading to severe corneal damage and blindness if not treated. We retrospectively examined the efficacy and safety of pooled human albumin eye drops (haeds) for symptom relief in 40 stem-cell transplantation patients after other alternatives had failed.

Methods

The Common Terminology Criteria for Adverse Events (version 4.0) and the cgvhd grading scale were used to compare response in the patients during January 2000 and July 2013. In addition, on days 1 and 30, the haeds were subjected to quality assurance testing for sterility, oncotic pressure, albumin measurement, viscosity, pH, and purity by protein electrophoresis.

Results

Use of haeds resulted in symptom relief for 37 patients (92.5%); 3 patients (7.5%) failed to improve with use of haeds (p ≤ 0.0001). Of the 37 patients having symptom relief, 7 (19%) improved from grade 3 to no dry eye symptoms. Proportionately, post-treatment symptom improvement by two grade levels, from 3 to 1 (70%), was significantly higher than improvement by one grade level, from 3 to 2 (11%) or from 2 to 1 (19%, p ≤ 0.0001). Time to symptom relief ranged from 2 weeks to 28 weeks. Of the 40 patients, 38 (95%) had no adverse reactions. Days 1 and 30 quality assurance testing results were equivalent.

Conclusions

Complications of keratoconjunctivitis sicca were well managed and well tolerated with haeds when other remedies failed. Quality assurance testing confirmed that haeds were safe and stable in extreme conditions.

3.
Albumin Drops: An Example Protocol

Still have not found an exact protocol. How are the drops sterilized exactly?

What You Need to Know About Your
Albumin Eye Drops
Information for patients and families
Remember:
9 Order your eye drops from the Princess Margaret Outpatient
Pharmacy 14 business days before you need them. They take
7 to 10 business days to make.
9 Keep eye drops in the freezer until the first time you use them.
Once you open a bottle, you can keep it in the refrigerator or
at room temperature for up to 24 hours. You must use a new
bottle every day.
9 Don’t let anyone else use your eye drops. They are made just
for you.
My albumin eye drops will be ready on:

The Outpatient Pharmacy at Princess Margaret Cancer Centre will call you to
let you know when they are ready.
You must pick up your eye drops.
They can’t be delivered to you because they must be kept frozen.
Form: D-5699
2
What are albumin eye drops?
Albumin eye drops help treat very dry eyes when other eye products don’t
work. Albumin is a protein that is found in your blood.
How can I order albumin eye drops?
You need a prescription from your doctor to order albumin eye drops. Bring
your prescription to the Princess Margaret Outpatient Pharmacy on the
main floor of Princess Margaret Cancer Centre. We make albumin eye drops
just for you. They cannot be used by anyone else.
How long does it take to make my albumin eye drops?
It takes about 7 to 10 business days to make your albumin eye drops. Bring
your prescription to the pharmacy 14 business days before you need them.
This will give us time to get your eye drops ready.
3
Why does it take so long to make albumin eye drops?
There are many steps we take to make sure your eye drops are safe and
sterile (free of germs). After you bring in your prescription:
1. We order albumin from the blood bank and special albumin eye dropper
bottles.

2. We receive the eye dropper bottles and send them to Toronto General
Hospital so they can be sterilized. This takes about 2 days.

3. After they are sterilized, the bottles are sent to the Princess Margaret
Inpatient Pharmacy (another pharmacy in the hospital).

4. The Inpatient Pharmacy staff carefully makes the eye drops to make
sure the drops are clean and safe to use.

5. The Inpatient Pharmacy staff calls us to let us know the albumin eye
drops are ready to pick up.

6. We do a final check at the Outpatient Pharmacy before we call you to
pick up your drops.
You must pick up your eye drops. They can’t be delivered to you because
they must be kept frozen.
How do I store my albumin eye drops at home?
Keep your albumin eye drops in the freezer until the first time you use
them. You must thaw the bottle before using it. Thaw only one bottle a day.
Once you open the bottle, you can keep it in the refrigerator or at room
temperature for up to 24 hours. You must use a new bottle every day.
Albumin eye drops are good for 40 days from when they are made. Please
check the expiry date on your eye dropper bottles.
How can I order more albumin eye drops?
Please call the Princess Margaret Outpatient Pharmacy at 416 946 6593 at
least 14 business days before you need more eye drops.
Visit www.uhnpatienteducation.ca for more health information.
Contact us to provide feedback or request this brochure in a different format, such as
large print or electronic formats: pfep@uhn.ca
© 2019 University Health Network. All rights reserved.
Use this material for your information only. It does not replace advice from your doctor or other health care professional.
Do not use this information for diagnosis or treatment. Ask your health care provider for advice about a specific medical
condition. You may print 1 copy of this brochure for non-commercial and personal use only.
Form: D-5699 | Author: Princess Margaret Outpatient Pharmacy | Revised: 08/2019