Serum Tear Production for Dry Eyes

CHAPTER 1

Hello, my name is Alex, Dr. Martin. I'm the Medical Director for Boston Vision Lawrence. And today we're gonna make serum tears for a patient that has really severe dry eye. So with serum tears, we use this on very severe dry eye cases. And what I'm actually doing is we have a phlebotomist come in, they draw four vials of blood for us from the patient, and then over the course of about 30, 40 minutes, we're able to create their own actual tears for them. So we take a concentration of serum from the blood, and I dilute that into a BSS salt solution. And we usually shoot for about at least 30%. And patients can use these drops four times a day, up to six times a day. And this is for pain and really severe dry eye cases.

CHAPTER 2

So I'm gonna take the patient's blood that's been coagulating for 20 minutes and I'm gonna put that into our centrifuge to spin for another 20 minutes. And the protocol there is that it spins at 350 RPMs for that 20 minutes. Part of any centrifuge safety is that everything is balanced and that you don't have an imbalanced centrifuge, like that situation. So since everything is symmetrical, caps are on, I'm okay to start the centrifuge. Perfect.

CHAPTER 3

So now that I've made them, I'll show that there's two mLs of solution in there and that I'm gonna be combining one mL to make a total of like a 30% solution.

CHAPTER 4

So our vials have finished after 20 minutes. We have separation of the serum from the rest of the blood. And so now I'm gonna take this out, and put it into my other vials, so I can get a concentration of about 30% for this. I like to actually just leave the vials in there one at a time. That way we don't risk knocking them over, breaking, anything like that. I will go ahead and just clean the tops with alcohol now, and get that step out of the way. And I've put, I believe it's a 16-gauge needle on the end of a three-mL syringe. Pull some air. Since this is a vacuum seal. I can invert, pull out serum. And then I'm gonna put about one mL into each one of these vials. Good. I'll leave any extra and go back for it later if I need extra. Actually on this one, let's put a little bit more air in there. Good. Don't want to overfill with air. And then we're gonna have, looks like some extra in this case, which is great, 'cause then I can end up making a higher concentration for the patient. Good. One extra vial. There we go. Good. We have plenty here. So now that we have our solution all made up, cap it back up. And so now we have made serum tears for the patient in at least a 30% concentration. And we use these for cases of extreme dry eye, individuals that may have arthritic conditions, rheumatoid conditions, that end up causing a more severe dry eye, such as Sjogren's syndrome. We can use this for patients with non-healing ulcers. We can do this for patients with severe pain from dry eye. Our big advantage to making these tears for people is that we're giving them their natural growth factors that are in their blood, and not relying on eyedrops to dilute what's on the surface of their eyes. We have people do these tears about four times a day. And this amount should get them about a three-month supply. So using this four times a day, you keep these frozen, and then on the week that you're actually using the vial, you take that out, keep it in the fridge so it's still cold. And then once you've gone through a week, you go to the next one, take it outta the freezer. That way you're making sure that you keep your supply. At this point, I can go ahead and take off gloves. Vials are in, we have a sticker to make sure that it's gonna go to the right patient. We can actually throw a nice cold compress in there. Keep those nice and cold for the patient as well on their way home. And we give a set of instructions as far as how often to do these. And that's the four times a day, the vial for the week in the fridge. The rest of your vials stay in the freezer. All right, thank you so much.

CHAPTER 5

With these serum tears, one of the big advantages for us is that we're able to take the patient's own blood, and just dilute that down and give them an eye drop that's actually themselves, and not necessarily an eye drop that's manufactured. If you think about our tear film, it's made up of over 3,000 different components. You're never gonna be able to make an eye drop that's gonna replicate that. So one of the closest things we have is serum tears. And we can use this to treat a variety of conditions. People that are in lots of pain, people that have very severe dry eye, people that have dry eye because of rheumatoid conditions. So it's actually really, really effective for those people. We do it anywhere from three to four times, maybe even six times a day, depending on the patient, or how long they've been doing it. And each vial lasts for about a week. We keep the rest of the stock in the freezer, and the vial that they're using is the one that's in the fridge that they actually use. And this, usually, we make about like a three to four month supply at a time.