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Contamination Risk of 100% Autologous Serum Eye Drops in Management of Ocular Surface Diseases

Thanathanee, Onsiri MD; Phanphruk, Warachaya MD; Anutarapongpan, Orapin MD; Romphruk, Amornrat PhD; Suwan-apichon, Olan MD

doi: 10.1097/ICO.0b013e3182910036
Clinical Science

Purpose: To evaluate the sterility and safety of 100% nonpreserved, autologous, serum eye drop treatment in patients with ocular surface diseases.

Methods: A total of 147 autologous serum bottles (294 samples) from 21 patients with ocular surface diseases were included. Seven bottles with autologous serum were prepared for each patient, and each bottle was used for only 1 day, then discarded. Two samples from each bottle were taken (before use and after 24 hours of use) and then cultured in standard media. The culture plates were held for at least 6 weeks or until no growth could be confirmed. To monitor safety, all patients were admitted and evaluated for the occurrence of infection.

Results: In the pretreatment group, 4 samples from 4 patients (1.36%) were positive for bacteria and 7 samples from 7 patients (2.38%) were positive for fungi. In the 24-hour-after-treatment group, 1 culture (0.34%) was positive for bacteria, and 6 samples (2.04%) from 6 patients were positive for fungi. Aspergillus spp and Fonsecaea spp were the most common organisms identified in any of the cultures. Neither clinical nor microbiological evidence of infection was demonstrated in any patient during the treatment or follow-up periods.

Conclusions: Although no ocular surface infection was observed, the patients under 100% autologous serum eye drops therapy should be closely monitored for clinical evidence of fungal and bacterial infections.

*Department of Ophthalmology, Faculty of Medicine, and

Blood Bank Unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Reprints: Olan Suwan-apichon, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand (e-mail:

Supported by the Research Affairs, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University.

The authors have no funding or conflicts of interest to disclose.

This study was approved by the Ethics Committee (HE521207) at the Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Received December 12, 2012

Accepted March 07, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.