ABSTRACT
Corneal diseases are a major cause of vision loss and blindness worldwide, second only to the impact of cataracts in overall importance. Corneal blindness is a major global health problem and the underlying causes are mainly avoidable either through prevention or early treatment. In this entry, we focus on current treatment strategies to address corneal blindness with a special emphasis on tissue engineering-based approaches. The most widely performed treatment strategy for corneal-associated blindness is corneal transplantation or keratoplasty, including penetrating and lamellar keratoplasty. Because of inadequacies associated with current corneal transplantation strategies, there is an increasing tendency for the ophthalmic community to develop alternative strategies including keratoprosthesis and tissue engineering. Keratoprostheses intended to restore vision of patients with severe corneal disease where corneal transplantation has repeatedly failed or is not an option, however, are associated with several drawbacks including glaucoma and retinal detachment. Tissue-engineered corneal substitutes represent a highly promising treatment option for corneal blindness as they mimic the biomechanical environment of the native cornea and have superior integration capabilities. Currently, a wide range of tissue-engineering-based strategies has been established and is being investigated clinically as an alternative to the routinely used techniques. Tissue engineering-based strategies include reconstruction of a full-thickness corneal equivalent or any of the typical corneal layers (i.e., epithelium, stroma, and endothelium). Transplantation of the tissue engineered full-thickness corneal substitute has shown a satisfactory success rate in human subjects. Tissue-engineered corneal substitutes represent an innovative strategy to replace corneal structure and function with subsequent vision restoration.
