Abstract: Mesenchymal stem cells (MSCs) are multipotent stem cells with anti-inflammatory, immunomodulatory, damage repair, and tissue regeneration properties, and they have the capability to produce extracellular vesicles. These vesicles derived from MSCs retain similar therapeutic characteristics as the stem cells themselves and offer advantages such as easier storage and transport, as well as a lower risk of carcinogenesis. In  models of ocular surface disease, mesenchymal stem cells can alleviate the symptoms of hydration-deficient dry eye by modulating the immune response and inhibiting the progression of inflammation, promoting corneal tissue regeneration, and increasing the number of lacrimal acinars. For pterygium, MSCs reduce tissue invasiveness by inhibiting fibroblast migration. Additionally, they relieve ocular discomfort in patients with graft-versus-host disease by reprogramming macrophages to suppress inflammation. Furthermore, MSCs help in alleviating symptoms of allergic conjunctivitis and improving the prognosis of chemical eye injuries. Although clinical trials are underway to validate the efficacy of mesenchymal stem cells in ocular surface diseases, the evidence is still insufficient. (Int Rev Ophthalmol, 2025, 49:  68-74)

Key words: mesenchymal stem cells, extracellular vesicles, ocular surface, dry eye disease, pterygium