Research and development of artificial
corneas (keratoprostheses) in recent years have evolved from the use of rigid hydrophobic materials such as
plastics and
rubbers to hydrophilic, water-swollen
hydrogels engineered to support not only peripheral tissue integration but also
glucose diffusion and surface
epithelialization. The advent of the AlphaCor core-and-skirt
hydrogel keratoprosthesis has paved the way for a host of new approaches based on
hydrogels and other
soft materials that encompass a variety of materials preparation strategies, from synthetic
homopolymers and
copolymers to collagen-based bio-copolymers and, finally, interpenetrating
polymer networks. Each approach represents a unique strategy toward the same goal: to develop a new
hydrogel that
mimics the important properties of natural donor
corneas. We provide a critical review of these approaches from a materials perspective and discuss recent experimental results. While formidable technical hurdles still need to be overcome, the rapid progress that has been made by investigators with these approaches is indicative that a synthetic donor
cornea capable of surface
epithelialization is now closer to becoming a clinical reality.
