Artificial cornea: Myth or reality?

Abstract

AbstractSince the first human corneal transplantation was performed by Eduard Zirm over 110 years ago, the paradigm of using human donor corneas for treating blinding corneal disease has remained largely unchanged. Intense research efforts, however, have been undertaken during the past decades, to engineer an alternative to the human cornea to meet the large global demand for this specialized donor tissue. The various artificial, or engineered corneas that have reached preclinical and in several cases clinical testing during the past years will be presented, along with the advantages and limitations of each technology. Various technologies use either cell‐free or cell‐loaded tissues, de‐cellularized or re‐cellularized human or animal tissues, and aim to replace various layers of the cornea or in certain cases, the entire cornea. For the most prevalent indications for corneal transplantation, however, human donor tissue remains the method of choice due to the unparalleled visual outcomes. Nevertheless, newer emerging treatment methods and alternatives to donor cornea transplantation are being reported, that can potentially ease the global demand for donor tissue and tissue banking in the future. Here we present these developments and provide the latest update on the most promising engineered corneal replacements tested in the clinic.