This literature review evaluated current and emerging biomaterial-based strategies for corneal repair and replacement, covering biological scaffolds (decellularized matrices, collagen-based implants, amniotic membrane), 3D-printed/bioprinted constructs, endothelial carrier systems, and synthetic/biologic keratoprostheses across all corneal layers.
Endothelial tissue engineering showed particularly encouraging early results; keratoprostheses remain the most clinically mature option for end-stage disease but are limited by incomplete biointegration. Key barriers across all platforms include long-term durability, optical stability, manufacturability, and regulatory complexity.
- Review scope does not include primary clinical trial data or direct outcome comparisons between platforms. - No sample sizes, effect sizes, or controlled comparisons are reported. - Regulatory and translational barriers are noted but not quantitatively assessed.
Clinicians should be aware that corneal biomaterials are moving from passive scaffolds toward layer-specific regenerative tools, but none yet match conventional keratoplasty in clinical evidence. Keratoprostheses (e.g., Boston KPro) remain the best-evidenced option for end-stage corneal failure while bioengineered alternatives continue to mature.
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