Autologous Serum Eye Drops: A Systematic Review, Part II—Clinical Application and Outcomes

This two-part review provides a comprehensive overview of autologous serum eye drops (ASEDs), addressing their composition, biological properties, and preparation protocols (Part I), as well as their clinical application in ocular surface diseases (Part II). Part II comprises a systematic review of the current evidence on ASEDs, including therapeutic indications, administration protocols, and treatment outcomes, particularly in patients with dry eye disease (DED) and persistent epithelial defect (PED). Clinical studies frequently report statistically significant improvements in ocular surface staining, tear film break-up time, epithelial healing, conjunctival impression cytology findings, and patient-reported symptoms following ASEDs therapy. Beneficial effects have been described particularly in DED associated with Sjögren syndrome, severe idiopathic DED, and ocular graft-versus-host disease, as well as in filamentary keratitis and postoperative ocular surface complications. ASEDs can support corneal nerve recovery and improve corneal sensitivity in neurotrophic keratopathy and can alleviate neuropathic corneal pain. Systematic searches of PubMed and Web of Science were performed on 15 September 2026 and identified 572 records, of which 502 were screened and 273 were assessed for eligibility. After inclusion of eligible human clinical studies from the personal literature database and removal of overlap, 191 studies, including randomized and non-randomized clinical trials, observational studies, case series, and case reports, were included. Formal risk-of-bias assessment and certainty-of-evidence grading were not performed. Despite considerable variability in preparation protocols, dosing regimens, and study design, available evidence supports the use of ASEDs as an effective supportive treatment and long-term therapeutic option in patients with moderate to severe ocular surface disease.