Heal Eye Pain after LASIK: Use of Cord Blood Serum (CBS) for Dry Eyes

There are patients who have chronic eye pain and dryness after LASIK. This rare but potentially debilitating chronic pain syndrome is thought to be due to neurotrophic keratitis: the nerves have been severed and do not heal back to normal as they usually do.

Researchers used 20% Cord Blood Serum (CBS) in neurotrophic keratitis cases and showed it improved the healing of epithelial defect and improvds corneal sensitivity (Ref 1-3). Similar studies also establish the efficacious role of CBS in healing persistent epithelial defects.

When both CBS and Autologous Serum (AS) are compared, 20% CBS had been more effective in decreasing symptoms and keratoepitheliopathy in severe dry eye syndrome and increasing goblet cell density in Sjogren’s syndrome than 20% AS drops.

The umbilical cord blood is collected from the placenta obtained from elective caesarean section cases performed in the departments of obstetrics usually. Written informed consent is obtained from the mothers undergoing caesarean section. Screening for syphilis, hepatitis B, hepatitis C and HIV is done. The blood (100 mL) is collected by directly cannulating the umbilical vein under sterile conditions. The blood is allowed to drain by gravity from the placenta. No anticoagulant is used during the procedure. The blood is allowed to coagulate and the supernatant serum is centrifuged at 1500 rpm for 5 min. It is then diluted using sterile saline solution and given to the patients in glass containers as a 20% solution. No antibiotic preservative are used. The serum is usually dispensed in sterile glass dropper bottles labelled with date of production.

The patients are instructed to store the bottles (3 mL) frozen and to open a new bottle each day for application. The used bottles are to be returned to the prescribing eyeMD each visit. They are instructed to report to the office immediately if there was any discoloration or thread-like floating objects noted in the serum.

No infection has been reported to date in the cornea.

We have found a supplier of Cord Blood for our patients. I hope to be able to provide this option for patients that have not been helped with other dry eye treatments.

Sandra Lora Cremers, MD, FACS

References:

1. Yoon KC,
2. You IC,
3. Im SK,
4. et al
. Application of umbilical cord serum eye drops for the treatment of neurotrophic keratitis. Ophthalmology 2007;114:1637–42.
↵
1. Vajpayee RB,
2. Mukerji N,
3. Tandon R,
4. et al
. Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects. Br J Ophthalmol 2003;87:1312–16.
↵
1. Yoon KC,
2. Heo H,
3. Jeong IY,
4. et al
. Therapeutic effect of umbilical cord serum eye drops for persistent corneal epithelial defect. Korean J Ophthalmol 2005;19:174–8.
↵
1. Noble BA,
2. Loh RS,
3. MacLennan S,
4. et al
. Comparison of autologous serum eye drops with conventional therapy in randomised controlled crossover trial for ocular surface disease. Br J Ophthalmol 2004;88:603–4.

Br J Ophthalmol. 2015 Jan;99(1):108-12. doi: 10.1136/bjophthalmol-2013-304801. Epub 2014 Aug 19.

Comparative role of 20% cord blood serum and 20% autologous serum in dry eye associated with Hansen’s disease: a tear proteomic study.

Mukhopadhyay S1, Sen S2, Datta H2.

Author information

Abstract

BACKGROUND:

To compare the role of topically applied serum therapy with preservative-free artificial tear (AT) drops in patients with moderate to severe dry eye in Hansen’s disease along with change in tear protein profile.

METHODS:

144 consecutive patients were randomly divided into three groups. After a baseline examination of clinical parameters, each of the patients received designated modality of topical therapy six times a day for 6 weeks. Post-treatment documentation of clinical parameters was done at 6 weeks, and then at 12 weeks after discontinuation of topical therapy. Analysis of three tear proteins using gel electrophoresis (sodium dodecyl sulfate polyacrylamide gel electrophoresis) was done at baseline, at the first and second post-treatment visits.

RESULTS:

In the cord blood serum (CBS) group, except for McMonnies score and staining score, all other clinical parameters showed continued improvement in the first and second post-treatment analyses. In the autologous serum (ALS) group, all the clinical parameters except Schirmer’s I showed significant improvement in the first post-treatment analysis .This was sustained at a significant level in the second analysis except for tear film break-up time (TBUT) and conjunctival impression cytology grading. In the AT group, all the parameters improved at a non-significant level except for TBUT in the first analysis. In the next analysis, apart from McMonnies score and TBUT, other clinical parameters did not improve. In the ALS and CBS groups, tear lysozyme, lactoferrin levels improved in both post-treatment measurements (statistically insignificant).Total tear protein continued to increase at statistically significant levels in the first and second post-treatment analyses in the CBS group and at a statistically insignificant level in the ALS group. In the AT group, the three tear proteins continued to decrease in both the analyses.

CONCLUSIONS:

In moderate to severe dry eye in Hansen’s disease, serum therapy in comparison with AT drops, improves clinical parameters and causes betterment in tear protein profile.

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