角膜疾病是全球中度至重度视力障碍和失明的主要原因之一,青光眼后,白内障,和视网膜疾病的整体重要性。鉴于它比白内障和青光眼等其他致盲疾病更容易影响患者,角膜瘢痕对个人和社会都构成了巨大的负担。此外,角膜瘢痕和纤维化不成比例地影响着贫困和偏远地区的人们,使其成为一个重大的眼科公共卫生问题。传统医学策略,比如外用皮质类固醇,不能有效预防纤维化或疤痕。角膜移植,角膜疤痕唯一有效的视力恢复治疗方法,受到包括组织严重短缺在内的挑战的遏制,移植排斥,次要条件,文化障碍,缺乏训练有素的外科医生,手术室,和设备齐全的基础设施。由于巨大的研究努力,新兴的治疗选择,包括基因治疗,蛋白质疗法,细胞疗法和新型分子正在开发中,以防止角膜瘢痕形成的进展,并补充目前可用于治疗临床上已建立的角膜瘢痕的手术选择。在这篇文章中,我们总结了近年来关于角膜瘢痕形成治疗的最相关的临床前和临床研究,显示这些方法如何在早期发展中防止瘢痕形成。
Corneal diseases are one of the leading causes of moderate-to-severe visual impairment and blindness worldwide, after glaucoma, cataract, and retinal disease in overall importance. Given its tendency to affect people at a younger age than other blinding conditions such as cataract and glaucoma, corneal scarring poses a huge burden both on the individuals and society. Furthermore, corneal scarring and fibrosis disproportionately affects people in poorer and remote areas, making it a significant ophthalmic public health problem. Traditional medical strategies, such as topical corticosteroids, are not effective in preventing fibrosis or scars. Corneal transplantation, the only effective sight-restoring treatment for corneal scars, is curbed by challenges including a severe shortage of tissue, graft rejection, secondary conditions, cultural barriers, the lack of well-trained surgeons, operating rooms, and well-equipped infrastructures. Thanks to tremendous research efforts, emerging therapeutic options including gene therapy, protein therapy, cell therapy and novel molecules are in development to prevent the progression of corneal scarring and compliment the surgical options currently available for treating established corneal scars in clinics. In this article, we summarise the most relevant preclinical and clinical studies on emerging therapies for corneal scarring in recent years, showing how these approaches may prevent scarring in its early development.