Department of Ophthalmology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, P.R. China; Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Surv Ophthalmol. 2018 Jul-Aug;63(4):453-479. doi: 10.1016/j.survophthal.2017.12.008. Epub 2017 Dec 27.
Corneal transplantation has been proven effective for returning the gift of sight to those affected by corneal disorders such as opacity, injury, and infections that are a leading cause of blindness. Immune privilege plays an important role in the success of corneal transplantation procedures; however, immune rejection reactions do occur, and they, in conjunction with a shortage of corneal donor tissue, continue to pose major challenges. Corneal immune privilege is important to the success of corneal transplantation and closely related to the avascular nature of the cornea. Corneal avascularity may be disrupted by the processes of angiogenesis and lymphangiogenesis, and for this reason, these phenomena have been a focus of research in recent years. Through this research, therapies addressing certain rejection reactions related to angiogenesis have been developed and implemented. Corneal donor tissue shortages also have been addressed by the development of new materials to replace the human donor cornea. These advancements, along with other improvements in the corneal transplantation procedure, have contributed to an improved success rate for corneal transplantation. We summarize recent developments and improvements in corneal transplantation, including the current understanding of angiogenesis mechanisms, the anti-angiogenic and anti-lymphangiogenic factors identified to date, and the new materials being used. Additionally, we discuss future directions for research in corneal transplantation.
角膜移植已被证明可有效恢复因角膜混浊、损伤和感染等疾病而失明患者的视力,这些疾病是导致失明的主要原因。免疫特惠在角膜移植手术的成功中起着重要作用;然而,免疫排斥反应确实会发生,并且与角膜供体组织短缺一起,继续构成重大挑战。角膜免疫特惠对于角膜移植的成功很重要,与角膜的无血管特性密切相关。角膜无血管性可能会被血管生成和淋巴管生成过程破坏,出于这个原因,这些现象一直是近年来研究的重点。通过这项研究,已经开发并实施了针对某些与血管生成相关的排斥反应的治疗方法。通过开发新材料来替代人供体角膜,也解决了角膜供体组织短缺的问题。这些进展以及角膜移植程序的其他改进措施,使角膜移植的成功率得到提高。我们总结了角膜移植的最新进展和改进,包括对目前对血管生成机制的理解、迄今为止确定的抗血管生成和抗淋巴管生成因子以及正在使用的新材料。此外,我们还讨论了角膜移植研究的未来方向。