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间充质干细胞(MSCs)具有免疫调节和促血管生成的特性，在细胞治疗中具有广泛的应用前景。外泌体是一类具有脂质双分子层结构的纳米级小囊泡。近年研究表明，外泌体具有与MSCs类似的生物学功能，可替代MSCs用于多种疾病的治疗。间充质干细胞来源外泌体(MSCs-exo)被广泛应用于包括葡萄膜炎、青光眼、视网膜和眼表疾病在内多种眼科疾病的治疗研究。然而，MSCs-exo内容物复杂，功能多样，为避免被免疫系统快速清除、提升靶向细胞特异性、减少不良反应，需要对外泌体进行不同策略修饰。如MSCs-exo内容物修饰后，使治疗因子过度表达，可最大限度地发挥其对特定眼病治疗的潜力和疗效，有望成为眼病治疗的新选择。本文重点阐述MSCs-exo应用和外泌体修饰的策略和现状，并探讨MSCs-exo修饰在眼病治疗中的潜在应用前景。“,”Mesenchymal stem cells (MSCs) were extensively explored as new therapeutic agents in cell-based therapy due to their immunomodulatory and pro-angiogenic characteristics.Exosomes are nanovesicles surrounded by a phospholipid layer.Recent studies have demonstrated that MSCs-derived exosomes (MSCs-exo) and MSCs have similar functions.MSCs-exo are considered as an ideal treatment for multiple ocular diseases including uveitis, glaucoma, retinal and ocular surface diseases.However, with complex contents and diverse functions, exosomes need to be modified with different strategies to avoid rapid clearance by the immune system, reduce side effects, enhance target cell specificity, and improve intracellular delivery efficiency.After the modification of MSCs-exo contents, specific therapeutic factor could be overexpressed in MSCs-exo in order to maximize their therapeutic potential and efficacy for specific eye diseases, which is expected to be a new choice for the treatment of eye diseases.This paper focuses on the applications of MSCs-exo and the current researches of exosomes modification strategies, and discusses the potential application prospects of modified MSCs-exo in the treatment of eye disease.