Harnessing the Underutilized Potential of Lens Capsule Transplantation in Ophthalmology: A Narrative Review of
1Ophthalmology, Skellefteå Eye Clinic, Skellefteå, SWE.
Abstract:
The human lens capsule is a transparent and durable basement membrane routinely discarded during cataract surgery, exhibiting unique biochemical, biomechanical, and immunologic properties. This narrative review discusses validated ophthalmic applications across corneal, retinal, and glaucoma filtration surgeries. It emphasizes the capsule's emerging role as a tissue-engineering scaffold for cultivating corneal endothelial cells, limbal epithelial stem cells, and retinal pigment epithelial cells, demonstrating significant promise in regenerative ophthalmology. However, variability in harvesting techniques, small graft sizes, and limited long-term clinical data currently hinder its broader clinical implementation. Future directions highlight the necessity of standardizing capsule harvesting and preservation protocols, potentially in collaboration with eye banks, to enhance accessibility and utility. Additionally, this review explores speculative applications, including encapsulation devices for drug and cell delivery, ultraviolet cross-linking for keratoconus management, and novel scaffolds for optic nerve regeneration and retinal transplantation. While preliminary evidence strongly supports the capsule's versatility, rigorous clinical trials and comparative analyses remain essential to establish long-term safety, efficacy, and optimal surgical integration. Ultimately, harnessing this naturally available biomaterial represents a meaningful advancement in ophthalmology, opening new horizons for future research.
