Clinical evidence on allogeneic blood-derived eye drops in ocular surface and corneal diseases

To systematically review clinical studies on allogeneic blood-derived eye drops in ocular surface and corneal diseases.

A PRISMA-guided search of PubMed, Google Scholar, Scopus, Web of Science, and Embase (1985-September 2025) identified eligible clinical studies on allogeneic eye drops for ocular surface and corneal diseases. Two reviewers independently extracted data and assessed study quality using Joanna Briggs Institute tools.

Sixty studies (1733 participants; 2374 eyes) met inclusion criteria, with 1423 patients (1738 eyes) receiving allogeneic eye drops. The cohort included 929 females (53.6%), 562 males (32.4%), and 242 unspecified (14.0%), with a mean age of 42.3 ± 21.8 years. Indications were dry eye disease (30.0%), mixed ocular surface disorders (21.7%), ligneous conjunctivitis (20.0%), persistent epithelial defects, erosions, and ulcers (18.3%), neurotrophic keratopathy (5.0%), and chemical or toxin-related injuries (5.0%). Treatments comprised allogeneic serum (47.4%), umbilical cord serum (43.2%), cord blood platelet lysate (10.1%), platelet-poor plasma/fresh frozen plasma (6.0%), plasma rich in growth factors (2.1%), and platelet-rich plasma (0.5%). Across 1738 treated eyes, reported outcomes were generally consistent, with improvements observed in patient-reported symptoms, epithelial healing, visual outcomes, and adverse events reported in <2% of cases. In dry eye disease, the largest relative improvements were reported for symptom scores (28.3%) and epithelial healing (24.9%), with smaller gains in tear-based measures (14-17%). Mixed ocular surface disorders showed symptom relief (28.5%), epithelial healing (16.9%), and BCVA improvement (7.7%). Ligneous conjunctivitis achieved complete/near remission in 1.5%, persistent epithelial defects healed in 10.2% with 0.5% recurrence, neurotrophic keratopathy showed 2.1% resolution with improved sensitivity, and chemical burns achieved 2.0% complete closure with better clarity and vision. Overall, patient-reported symptoms and epithelial healing emerged as the most consistently responsive outcomes, while reported safety profiles remained favorable. While many studies demonstrated acceptable methodological quality within their respective designs, the overall evidence base was predominantly composed of observational and non-comparative studies, which limits overall certainty.

Allogeneic blood-derived eye drops are associated with meaningful clinical improvement across ocular surface diseases and demonstrate favorable short-to mid-term safety. Further controlled studies with standardized protocols, longer follow-up, and cost-effectiveness analyses are needed.