Corneal Regenerative Medicine: Corneal Substitutes for Transplantation

Abstract■ Corneal substitutes are needed to address the shortage of human donor tissues and the current disadvantages in some clinical indications, including immune rejection ■ Substitutes have been designed to replace part of or the full thickness of damaged or diseased corneas. They range from prostheses, known as keratoprostheses (KPros), through naturally fabricated, cell-based, tissue equivalents, to tissue-engineered scaffolds that serve as templates for the regeneration of host tissues ■ At present, widely accepted substitutes are not available although prostheses (KPros) have been in clinical testing or in limited clinical use ■ The trends toward replacement of only damaged portions of the cornea and replacement of the epithelium by corneal limbal cell transplant has been gaining momentum ■ Corneal substitutes that encourage regeneration of the host tissue may likely overcome the rejection problems and other postoperative complications of donor tissue transplantation and KPros ■ There will probably not be a single “onesize- fits-all” corneal substitute for all indications. Instead, a small range of corneal substitutes that are tailored to different clusters of clinical indications will be available