Current Perspectives on Corneal Transplantation (Part 2)

Abstract

Disease of the cornea is the third leading cause of blindness worldwide. Corneal graft surgery is one of the most successful forms of solid organ transplantations in humans, with ever increasing developments in surgical technique. To date, approximately 4504 corneal transplants are performed in the UK each year. While full thickness transplantation was the most commonly performed keratoplasty over the last few decades, selective lamellar transplantation of the diseased layers of the cornea has been universally adopted. This comprehensive review aims to provide an updated synthesis on different types of corneal transplantations, their treatment outcomes, and the associated complications of each procedure both in adult and pediatric populations. In addition, we also present an up-to-date summary of the emerging therapeutic approaches that have the potential to reduce the demand for donor-dependent keratoplasty.

Current Advances in Corneal Stromal Stem Cell Biology and Therapeutic Applications

“…The remaining cases of corneal opacification are due to a great number of other factors, such as onchocerciasis, vitamin A deficiency, tumors, and wounds [7,8]. An estimated 55.3% of the world's population does not have access to corneal transplant material [9][10][11][12]. The incidence of corneal blindness is particularly pronounced in countries within Asia, Africa, and the Middle East, where over 1 million new cases arise each year [13][14][15][16].…”

Evaluation of Lycium Shawii Schult & Roem Eye Drops as a Novel Treatment for Old Corneal Scars in Rabbits

“…Following corneal transplantation, a visually significant complication that can occur even years after initial surgery known as postpenetrating keratoplasty, corneal ectasia. Endothelial failure caused long-term failure [4,5]. Drug delivery to the corneal tissues is difficult and challenge because the mechanical barriers that protect the cornea as multi layered epithelium, tight junctions that limit ocular drug delivery.…”

“…Post penetrating keratoplasty corneal ectasia is a visually significant complication that can occur even years after initial surgery. Long-term failure was caused by endothelial failure [4,5]. The most common reasons for high failure rates are lax corneoscleral tissue, a more aggressive inflammatory response, persistent intraocular inflammation and glaucoma.…”

“…Regraft procedures also have failure rates of up to 80%. Graft survival in pediatric patients is less promising than in adult patients and is heavily dependent on the patient's age [5]. With penetrating keratoplasty, the Australian Corneal Graft Registry reported 89% graft survival at 5 years, 49% at 15 years, and 17% at 23 years.…”