Blood Derivatives in the Therapy of Ocular Surface Diseases.

The ocular surface is a structure crucial to maintaining eye health and proper vision. Unfortunately, ocular surface diseases functioning as chronic epithelial defects, inflammation, impaired healing, require immediate regenerative repair treatment that can restore tissue integrity and function. Conventional therapies, such as artificial tears and topical anti-inflammatory agents, principally provide symptomatic relief without addressing the underlying biological deficits, thus leading to incomplete or delayed recovery. Therefore, blood derivatives have emerged as a promising bioactive therapy that not only lubricates but also actively promotes regeneration through the delivery of cytokines, growth factors, and vitamins naturally present in blood. Due to their properties mimicking the components of natural tears, autologous origin, biocompatibility and capacity to enhance tissue repair, they have emerged as a cornerstone in regenerative medicine. Therefore, the purpose of this review was to compare the evolution, positive aspects, and drawbacks, in order to demonstrate the molecular mechanism of action and the therapeutic efficacy of different blood derivates at treating ocular surface disease. Over time, these biologic preparations have evolved from the use of simple traditional serum-based derivatives to more advanced platelet-rich products, underscoring the evolving understanding of platelet-driven molecular and cellular mechanisms in tissue regeneration. Despite their widespread use, we would like to highlight the current limitations related to the lack of standardized preparation protocols, variability in composition, and evidence-based integration into clinical practice. Finally, this review highlights contemporary research trends and depicts future directions advancing the field. Key priorities include the establishment of standardized, reproducible preparation protocols; the development of next-generation platelet-derived concentrates and biomaterials; and the integration of multi-omics technologies to achieve comprehensive profiling of their biological and therapeutic activity. Moving toward methodological standardization and the execution of well-designed, high-quality comparative clinical trials will be essential to reinforce the scientific foundation, enhance translational potential, and ensure the clinical reliability of blood-derived therapies in modern regenerative medicine.