Persistent keratitis, corneal ulcers, keratoconjunctivitis sicca, chronic exposure keratopathy, corneal neovascularization, and neurotrophic disease can be especially difficult to treat. Steroids, antibiotics, cyclosporin, lifitegrast and amniotic membranes may fail in some cases. Insurance may not cover medications deemed medically necessary. For some, using cyclosporin, loteprednol and artificial tears hourly is prohibitively expensive. In these cases, I am using autologous serum more often. Autologous serum and Platelet Rich Plasma have both been reported to be beneficial in the treatment of ocular surface disease. Homologous sources, including allogeneic serum obtained from healthy donors, and umbilical cord blood serum collected at the time of delivery are efficient alternatives when autologous serum therapy is contraindicated or not appropriate.(1) Advantages to using autologous serums include natural healing factors, and freedom from HIV, hepatitis, and other transmissible diseases.(2)
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