Artificial and Bioengineered Therapeutic Options for Corneal Endothelial Disease

Area of Science:

• Ophthalmology
• Biomaterials Science
• Regenerative Medicine

Background:

• Corneal endothelial dysfunction is a leading cause of corneal transplantation worldwide.
• Shortages in donor tissue and graft longevity drive the need for artificial alternatives.
• Artificial grafts are crucial for patients unsuitable for traditional allogeneic transplantation.

Purpose of the Study:

• To review the current status of artificial corneal endothelial grafts.
• To highlight technological advancements and surgical integration.
• To assess their role in meeting endothelial keratoplasty demands.

Main Methods:

• Comprehensive literature synthesis of preclinical and clinical studies.
• Focus on scaffold-based, cell-seeded, and acellular methods.
• Evaluation of biomaterials and surgical delivery techniques.

Main Results:

• Functional endothelial substitutes have been developed using regenerative biomaterials.
• Engineered grafts (decellularized carriers, polymer matrices, cell-laden constructs) show biocompatibility.
• Integration with Descemet membrane endothelial keratoplasty (DMEK)-like procedures demonstrates clinical viability and potential for visual recovery.

Conclusions:

• Artificial endothelial grafts represent a significant advancement in corneal surgery.
• They address donor tissue scarcity and expand endothelial keratoplasty applications.
• Further clinical validation is needed, but these technologies may soon revolutionize treatment for corneal endothelial diseases.