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Evolution of therapies for the corneal endothelium: past, present and future approaches

Corneal endothelial diseases are leading indications for corneal transplantations. With significant advancement in medical science and surgical techniques, corneal transplant surgeries are now increasingly effective at restoring vision in patients with corneal diseases. In the last 15 years, the int...

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Autores principales: Ong, Hon Shing, Ang, Marcus, Mehta, Jodhbir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005807/
https://www.ncbi.nlm.nih.gov/pubmed/32709756
http://dx.doi.org/10.1136/bjophthalmol-2020-316149
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author Ong, Hon Shing
Ang, Marcus
Mehta, Jodhbir
author_facet Ong, Hon Shing
Ang, Marcus
Mehta, Jodhbir
author_sort Ong, Hon Shing
collection PubMed
description Corneal endothelial diseases are leading indications for corneal transplantations. With significant advancement in medical science and surgical techniques, corneal transplant surgeries are now increasingly effective at restoring vision in patients with corneal diseases. In the last 15 years, the introduction of endothelial keratoplasty (EK) procedures, where diseased corneal endothelium (CE) are selectively replaced, has significantly transformed the field of corneal transplantation. Compared to traditional penetrating keratoplasty, EK procedures, namely Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), offer faster visual recovery, lower immunological rejection rates, and improved graft survival. Although these modern techniques can achieve high success, there are fundamental impediments to conventional transplantations. A lack of suitable donor corneas worldwide restricts the number of transplants that can be performed. Other barriers include the need for specialized expertise, high cost, and risks of graft rejection or failure. Research is underway to develop alternative treatments for corneal endothelial diseases, which are less dependent on the availability of allogeneic tissues – regenerative medicine and cell-based therapies. In this review, an overview of past and present transplantation procedures used to treat corneal endothelial diseases are described. Potential novel therapies that may be translated into clinical practice will also be presented.
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spelling pubmed-80058072021-04-16 Evolution of therapies for the corneal endothelium: past, present and future approaches Ong, Hon Shing Ang, Marcus Mehta, Jodhbir Br J Ophthalmol Review Corneal endothelial diseases are leading indications for corneal transplantations. With significant advancement in medical science and surgical techniques, corneal transplant surgeries are now increasingly effective at restoring vision in patients with corneal diseases. In the last 15 years, the introduction of endothelial keratoplasty (EK) procedures, where diseased corneal endothelium (CE) are selectively replaced, has significantly transformed the field of corneal transplantation. Compared to traditional penetrating keratoplasty, EK procedures, namely Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK), offer faster visual recovery, lower immunological rejection rates, and improved graft survival. Although these modern techniques can achieve high success, there are fundamental impediments to conventional transplantations. A lack of suitable donor corneas worldwide restricts the number of transplants that can be performed. Other barriers include the need for specialized expertise, high cost, and risks of graft rejection or failure. Research is underway to develop alternative treatments for corneal endothelial diseases, which are less dependent on the availability of allogeneic tissues – regenerative medicine and cell-based therapies. In this review, an overview of past and present transplantation procedures used to treat corneal endothelial diseases are described. Potential novel therapies that may be translated into clinical practice will also be presented. BMJ Publishing Group 2021-04 2020-07-22 /pmc/articles/PMC8005807/ /pubmed/32709756 http://dx.doi.org/10.1136/bjophthalmol-2020-316149 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Review
Ong, Hon Shing
Ang, Marcus
Mehta, Jodhbir
Evolution of therapies for the corneal endothelium: past, present and future approaches
title Evolution of therapies for the corneal endothelium: past, present and future approaches
title_full Evolution of therapies for the corneal endothelium: past, present and future approaches
title_fullStr Evolution of therapies for the corneal endothelium: past, present and future approaches
title_full_unstemmed Evolution of therapies for the corneal endothelium: past, present and future approaches
title_short Evolution of therapies for the corneal endothelium: past, present and future approaches
title_sort evolution of therapies for the corneal endothelium: past, present and future approaches
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005807/
https://www.ncbi.nlm.nih.gov/pubmed/32709756
http://dx.doi.org/10.1136/bjophthalmol-2020-316149
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