Biological topicals in ocular surface disorders.

Abstract

Topical biological agents represent a significant advancement in the treatment of ocular surface diseases, offering a regenerative and therapeutic approach beyond conventional therapies. These agents are derived from serum (autologous or allogeneic), platelets, amniotic membrane, and pooled intravenous immunoglobulin. Their efficacy stems from their rich composition of growth factors, cytokines, and anti-inflammatory molecules that promote tissue healing, reduce inflammation, and enhance corneal regeneration. Autologous serum eye drops, closely mimicking natural tears, have been widely utilized for conditions such as dry eye disease, neurotrophic keratopathy, and persistent epithelial defects. Similarly, platelet derivatives, including platelet-rich plasma (PRP) and platelet lysate (PL), have demonstrated accelerated wound healing and nerve regeneration benefits. Amniotic membrane extracts and human amniotic fluid eye drops share the anti-inflammatory and regenerative properties of the human amniotic membrane. Recent advancements have introduced the use of topical IVIG, which modulates immune responses in severe inflammatory dry eye conditions, such as ocular graft-versus-host disease. Despite these promising applications, challenges such as variability in preparation, storage limitations, and cost remain. Nevertheless, the future of topical biological agents is promising, with emerging recombinant therapies and personalized treatment approaches shaping modern ophthalmologic care. As research continues to expand, these agents are poised to become integral components in managing ocular surface disorders, improving patient outcomes, and reducing dependence on traditional therapies.