Efficacy of umbilical cord serum in ocular surface diseases: a systematic review
- 1Department of Ophthalmology, National University Hospital, Singapore
Abstract
Objective To systematically evaluate the efficacy, safety and clinical outcomes of umbilical cord serum (UCS) eye drops in the management of ocular surface diseases.Methods and analysis A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration). Databases were searched for studies evaluating UCS for ocular surface disorders. Eligible studies included randomised controlled trials, prospective and comparative interventional studies assessing epithelial healing, tear film parameters or symptom outcomes.Results 22 studies were included, encompassing 1126 patients. For persistent epithelial defect, UCS demonstrated complete healing in 58%–75% by day 21. UCS significantly shortened healing compared with artificial tears (16.7–22.5 days vs 29.0 days) and produced comparable efficacy to autologous serum (AS). In dry eye disease, nine studies reported significant improvement in symptom scores (mean Ocular Surface Disease Index reduction 14–30 points, I2=63%). Tear break-up time (TBUT) improved post-treatment (pooled mean difference (MD) 1.52 (95% CI –1.31 to 1.73)), though heterogeneity remained high (I2=94.7%). Schirmer’s test also showed modest improvement (MD 0.31 (0.02 to 0.59), I2=2.1%) with UCS. Comparative analyses found no consistent difference between UCS and AS in TBUT and Schirmer’s test. All studies assessing keratoepitheliopathy reported significant staining score reduction (p<0.05). For acute chemical burns, UCS demonstrated reductions in epithelial defect diameter and area by 3 months (I2=89%–99%). No major adverse events were reported in any study.Conclusion UCS appears to be a safe and effective biological tear substitute that promotes epithelial healing and improves tear film parameters across a spectrum of ocular surface diseases.PROSPERO registration number CRD420251173156.
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BibTeX
@article{lee2026efficacy,
title = {{Efficacy of umbilical cord serum in ocular surface diseases: a systematic review}},
author = {Deborah Mei Xuan Lee and Ray Manotosh and Hui-Chen Charmaine Chai and Dayna Wei Wei Yong},
journal = {BMJ Open Ophthalmology},
year = {2026},
month = nov,
doi = {10.1136/bmjophth-2026-003020},
url = {https://doi.org/10.1136/bmjophth-2026-003020},
note = {CC BY},
}
RIS
TY - JOUR
TI - Efficacy of umbilical cord serum in ocular surface diseases: a systematic review
AU - Deborah Mei Xuan Lee
AU - Ray Manotosh
AU - Hui-Chen Charmaine Chai
AU - Dayna Wei Wei Yong
PY - 2026
DA - 2026/11/08
JO - BMJ Open Ophthalmology
DO - 10.1136/bmjophth-2026-003020
UR - https://doi.org/10.1136/bmjophth-2026-003020
AB - Objective To systematically evaluate the efficacy, safety and clinical outcomes of umbilical cord serum (UCS) eye drops in the management of ocular surface diseases.Methods and analysis A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO registration). Databases were searched for studies evaluating UCS for ocular surface disorders. Eligible studies included randomised controlled trials, prospective and comparative interventional studies assessing epithelial healing, tear film parameters or symptom outcomes.Results 22 studies were included, encompassing 1126 patients. For persistent epithelial defect, UCS demonstrated complete healing in 58%–75% by day 21. UCS significantly shortened healing compared with artificial tears (16.7–22.5 days vs 29.0 days) and produced comparable efficacy to autologous serum (AS). In dry eye disease, nine studies reported significant improvement in symptom scores (mean Ocular Surface Disease Index reduction 14–30 points, I2=63%). Tear break-up time (TBUT) improved post-treatment (pooled mean difference (MD) 1.52 (95% CI –1.31 to 1.73)), though heterogeneity remained high (I2=94.7%). Schirmer’s test also showed modest improvement (MD 0.31 (0.02 to 0.59), I2=2.1%) with UCS. Comparative analyses found no consistent difference between UCS and AS in TBUT and Schirmer’s test. All studies assessing keratoepitheliopathy reported significant staining score reduction (p<0.05). For acute chemical burns, UCS demonstrated reductions in epithelial defect diameter and area by 3 months (I2=89%–99%). No major adverse events were reported in any study.Conclusion UCS appears to be a safe and effective biological tear substitute that promotes epithelial healing and improves tear film parameters across a spectrum of ocular surface diseases.PROSPERO registration number CRD420251173156.
SN - 2397-3269
ER -