A historical review of artificial cornea research in Japan

Little is known or understood about the history of artificial cornea (keratoprosthesis) in Japan, mainly because of the unavailability and linguistic inaccessibility of the relevant publications. Rather strangely also, the Japanese scholars themselves have manifested only slight interest in reviewing the topic, even in their own language. As a result, the research on artificial cornea in Japan showed in fact the same pattern of historical development as that seen in the Western world. After audacious beginnings in the 19th century, an interlude of about half a century followed, when the interest of ophthalmologists was deflected to penetrating keratoplasty as a means to fight corneal blindness. The introduction in medical use of man-made polymeric materials in the 1950s triggered a revival of research on artificial cornea in Japan, and the next two decades were rich in ideas, achievements, and a plethora of reports, all published in Japanese. In the 1980s, the developmental work on keratoprosthesis became incorporated into the field of biomaterials, and the creation of materials able to mimic the corneal tissue was established as a leading concept, resulting in original designs with some sophistication. At the same time. the English language started to be used extensively for dissemination of results. These trends have continued to date. Based on rigorous documentation, we traced the history of research on artificial cornea in Japan from its origin to our time.