Comparison of the Effect of Autologous Serum versus Preservative-Free Artificial Tears after Photorefractive Keratectomy: A Contralateral-Eye Clinical Trial
Journal of Ophthalmic and Optometric Sciences,
Vol. 9 No. 3 (2025),
22 June 2025,
Page 11-18
https://doi.org/10.22037/joos.v9i3.51181
Purpose: To compare 20 % autologous serum (AS) with preservative-free artificial tears (PFAT) for epithelial healing and early outcomes after photorefractive keratectomy (PRK).
Patients and Methods: Prospective, contralateral-eye clinical trial including 60 myopic patients (120 eyes). In each patient, one randomly assigned eye received 20 % AS and the fellow eye PFAT post-PRK. Primary outcome was time to complete epithelial closure. Secondary outcomes included day-by-day postoperative pain (Days 1–3), epithelial defect (ED) size (Days 1–2), corneal haze, and uncorrected visual acuity (UCVA) at 12 weeks. Standardized PRK technique and identical bandage contact lenses were used. Paired-eye statistics were applied (paired t-test or Wilcoxon as appropriate; χ² for categorical data; α=0.05).
Results: Epithelial closure time did not differ between groups (AS 3.00 ± 0.33 vs. PFAT 3.03 ± 0.21 days; P=0.655). Mean Day-1 pain was numerically lower with AS overall (AS 3.28 ± 1.75 vs. PFAT 3.60 ± 1.83), and significantly lower among women (AS 3.39 ± 1.96 vs. PFAT 4.11 ± 2.05; P = 0.003). Pain declined to near-zero by Day-2 in both groups (AS 0.07 ± 0.31 vs. PFAT 0.08 ± 0.38). ED size was similar on Day-1 (AS 5.50 ± 0.73 vs. PFAT 5.56 ± 0.73) and Day-2 (AS 3.33 ± 0.60 vs. PFAT 3.47 ± 0.79). No eye developed haze.
Conclusions: After PRK, 20 % AS and PFAT yield comparable epithelial closure (~3 days) and 12-week visual outcomes. AS may reduce early postoperative pain, particularly in women, warranting larger paired-eye trials to confirm this signal.