Clinical evidence and critical review of mesenchymal stromal cells for corneal and ocular surface diseases.

Abstract

Mesenchymal stromal cells (MSCs), owing to their regenerative and immunomodulatory properties, have emerged as a potential therapeutic option for disorders affecting the cornea and ocular surface. Early-phase clinical studies have begun to demonstrate the safety and, to some extent, efficacy of MSC-based therapies in conditions such as dry eye disease, persistent corneal epithelial defects, ocular chemical injuries, corneal scarring, keratoconus, and limbal stem cell deficiency. However, evidence from some studies suggests that MSC-related improvements may be short-lived. Currently, the appropriate clinical indications, delivery methods, and long-term outcomes remain unclear, necessitating further laboratory and clinical investigations. In this review, we summarize published and ongoing clinical studies on the therapeutic applications of MSCs for ocular surface diseases, including our own group's experience. We critically evaluate the strengths and limitations of existing studies and highlight gaps and opportunities in this evolving field.