Corneal transplantation: Restoring sight to the blind

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Transplantation Immunology

Background:

• Corneal blindness is a significant cause of vision loss worldwide.
• Corneal transplantation restores vision, with minimally invasive techniques like Descemet membrane endothelial keratoplasty (DMEK) and deep anterior lamellar keratoplasty (DALK) evolving.
• Penetrating keratoplasty remains common, particularly in high-risk cases, where blood and lymphatic vessels increase immune rejection risk.

Purpose of the Study:

• To present evidence for temporary pre-transplant lymphangioregression in the cornea as a novel strategy to enhance graft survival.
• To explore UVA-based crosslinking as a method to regress pathologic corneal vessels.
• To discuss advancements in DMEK, Descemet stripping only (DSO), and endothelial cell transplantation for high-risk patients.

Main Methods:

• Review of current evidence on lymphangioregression techniques.
• Application of UVA-based crosslinking for corneal vessel regression.
• Analysis of outcomes for DMEK in high-risk eyes and artificial endothelial transplants.

Main Results:

• Pathologic blood and lymphatic vessels are identified as key risk factors for immune reactions post-transplantation.
• UVA-based crosslinking shows potential as a method to regress pathologic corneal vessels.
• DMEK in high-risk eyes and artificial endothelial transplants can help prevent immune reactions.

Conclusions:

• Temporary pre-transplant lymphangioregression is a promising concept for improving corneal graft survival.
• Advancements in lamellar keratoplasty and endothelial cell transplantation offer new hope for patients with corneal blindness.
• Ongoing innovations in corneal transplantation are revolutionizing vision restoration for a global patient population.