Table 1 A summary of treatment approaches for corneal stromal regeneration
From: New dawn for keratoconus treatment: potential strategies for corneal stromal regeneration
Categories | Cell/tissue sources | Therapeutic method | Stage of research | Advantages | Limitations |
|---|---|---|---|---|---|
Cell-based therapies | Keratocytes from corneal stroma [20] | Intrastromal injection | Animal studies | A nonsurgical approach to revive the keratocyte population | Limited numbers; further work is needed |
Keratocyte progenitor cells from limbal rings [21] | Introduction into stroma via femtosecond laser channels | Hypothesis | The corneal rims which are usually discarded after keratoplasty, are potentially a plentiful source | Its safety and feasibility need to be explored | |
Engrafted in a fibrin gel on ocular surface | Animal studies | A nonsurgical approach to promote stromal regeneration and prevent scarring | Limited numbers; further work is needed for keratoconus treatment | ||
Prepared ADSCs were placed into the mid-stromal pocket | Phase I clinical study | Autologous cells; adipose tissue is abundant and easily accessible | More clinical testing should be down | ||
Hematopoietic stem cells [32] | Intrastromal injection | Animal studies | Autologous cells | Further studies are needed | |
Dental pulp [35] | Intrastromal injection | Animal studies | Autologous cells; adequate sources | Further studies are needed | |
Intrastromal injection | Animal studies | Adequate sources | Further work is needed for keratoconus treatment | ||
iPSCs [38] | Intrastromal injection | Cell lines | Adequate sources | Further studies are needed | |
Biosynthetic alternatives | RHCIII [39] | Implantation | Phase I clinical study | A safe and effective alternative to be implanted to help address the donor cornea shortage | More patients, modified surgical techniques and continued biomaterials development are needed |
Short collagen-like peptides conjugated to polyethylene glycol [41] | Implantation | Preclinical mini-pig model | A sufficiently robust for surgical handling implant which provide stable corneal tissue regeneration | More clinical testing should be down | |
LiQD cornea [42] | A cell-free, liquid hydrogel matrix applied on ocular wounding surface | Animal studies | Convenient, less costly and reduces the risk of immune rejection risk | More clinical testing should be down |