The Role of Biological Preparations in Treating Ocular Surface Disorders: A Literature Review
Autologous serum eye drops; Biological preparations; Dry eye disease; Ocular surface disorders; Platelet-rich plasma; Umbilical cord blood serum; Neurotrophic keratitis
AuthorsAbstractThe ocular surface disorders (OSDs) afflict the conjunctiva, the cornea, and the tear film, causing significant patient morbidity, visual impairment, and high costs of care. Historically, the treatment of OSDs has included artificial tears and anti-inflammatory medications. These methods provide only temporary symptomatic relief from signs/symptoms without necessarily addressing the underlying biological deficiency. Newer treatment modalities will be developed from biological products derived from deceased human beings. They will contain tissue-healing and regenerative factors present in the human tear film, i.e., growth factors, cytokines, and vitamins. We will conduct a literature search to provide a comprehensive overview of 65 studies published in peer-reviewed journals (2008-2025) that describe the efficacy, safety, and clinical use of autologous serum eye drops, allogeneic serum eye drops, PRP products, umbilical cord blood-derived products, topical insulin, and other biological preparations to treat corneal and/or ocular surface disease. 1. Introduction Ocular surface disease involves many conditions that affect tear function, damage the surface of the eye, and cause inflammation. It can affect the cornea, conjunctiva and other structures. Ocular surface disease may be caused by Dry Eye Disease (DED), Persistent Corneal Epithelial Defects (PED's), Neurotrophic Keratitis (NK), Chemical Burns, and immunologically-mediated disorders such as Graft Versus Host Disease and Sjögren's. In the case of DED, the estimated global prevalence is 29.5%, making its burden on the health care system considerable. Conventional methods of treatment include preservative-free artificial tears, anti-inflammatory medications applied to the eye and occlusion of the tear duct. These methods only relieve symptoms; they do not address the underlying biological conditions (Drew, 2018; Stępień, 2025). Biologically-based therapies include effective surgery, ocular surface lubrication, and ocular tissue regeneration, facilitated by bioactive materials found in healthy tears (Drew, 2018; Stępień, 2025). Consequently, there is now an increase in the use of biologically based therapies under Blood-derived products for ocular surface disease due to the similarity in the composition of blood serum to that of natural tears (Cui et al., 2021; Drew et al., 2018; Higuchi, 2018). Both comprise growth factors, vitamins, immunoglobulins and other epitheliotrophic factors that stimulate the corneal epithelium and instigate wound healing (Cui et al., 2021; Drew et al., 2018; Higuchi, 2018; Stępień, 2025). The first to use serum as a treatment in chemical burns and chronic keratitis were Ralph et al. (1975), setting the foundations for the modern utilisation of biological therapy in ophthalmology (Drew et al., 2018; Nair et al., 2025). We have tried in this review to summarise the recent evidence on the effectiveness, safety, and clinical applications of biological preparations for ocular surface disease, their pitfalls, and their future. 2. Methods:For this narrative literature review, we comprehensively •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.
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