Abstract: Objective To assess the clinical efficacy and safety of 20% autologous serum (AS) combined with artificial tears (AT) in treating moderate dry eye disease (MDED) after senile cataract surgery. Methods A retrospective study was conducted on 94 elderly patients with unilateral MDED after cataract surgery from 2023-2024. The patients were divided into the AS+AT group (47 cases) and the AT group (47 cases) based on treatment regimens. Both groups underwent 4 weeks of treatment. The evaluation indicators included Ocular Surface Disease Index (OSDI), corneal fluorescein staining (CFS), tear film breakup time (FBUT), corneal sensitivity, Schirmer Ⅰ test and tear inflammatory factor levels such as tumor necrosis factor(TNF)-α, interleukin(IL)-6, IL-1β, and the adverse events were recorded. Results The total effective rate was significantly higher in the AS+AT group than that in the AT group (78.7% vs 63.8%). The normalization rate of corneal sensitivity after treatment was improved significantly in both groups, especially in the AS+AT group (P<0.05). FBUT and Schirmer Ⅰ test results showed significant differences between the AS+AT group and the AT group(P<0.05), while OSDI or CFS showed no significant differences (P>0.05). The levels of inflammatory factors (TNF-α, IL-6, IL-1β) decreased significantly in both groups after treatment, especially in the AS+AT group (P<0.05). No statistically significant difference was found in the total adverse event rate between the two groups (4.26% vs 2.13%). Conclusions AS combined with AT therapy significantly enhances the clinical efficacy in the elderly patients with unilateral MDED after cataract surgery with favorable safety, improves corneal sensitivity and tear film stability, and effectively reduces the levels of inflammatory factors.

Key words: autologous serum, artificial tears, moderate dry eye disease, senile cataract