Autologous Serum Tears in the Management of Ocular Surface Diseases: A Comprehensive Review of Published Evidence.

PURPOSE: This comprehensive review evaluates the efficacy and safety of autologous serum (AS) tears in managing dry eye disease (DED) by analyzing published prospective randomized controlled trials (RCTs).

METHODS

A comprehensive literature search was conducted in PubMed, Scopus, and the Cochrane Library up to February 28, 2025. The primary outcome measures included symptom improvement, Schirmer's test, tear break-up time, ocular surface staining, and visual performance. The Cochrane Risk of Bias Version 2 tool was used to assess study quality.

RESULTS

Six RCTs (102 participants, 169 eyes) were included. Significant symptom improvement was recorded with AS tears 20%. The most consistent improvement in clinical signs was observed with AS tears 50%. The risk of bias assessment identified only one study as high risk due to lack of blinding.

CONCLUSION

AS tears show promise for moderate-to-severe DED, but variability in study design and small sample sizes necessitate standardized protocols and larger RCTs.