Wiley

Eye & ENT Research

Published by Wiley and Higher Education Press

Online ISSN: 2835-1088

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Print ISSN: 2835-107X

Disciplines: Otolaryngology (ear, nose & throat)

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Top-read articles

13 reads in the past 30 days

Cataract blindness related falls among older adults: A prospective cohort study in Ghana

December 2024

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35 Reads

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Regina Adoma Antwi

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Madison Adanusa

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[...]

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Background Cataract, the leading cause of blindness worldwide, can significantly impair visual function. Purpose This study investigated the association between cataract‐related falls among the elderly population in the Central region of Ghana. Methods The prospective cohort study among cataract patients aged 65 years and older, using purposive sampling to select facilities and consecutive sampling to recruit participants. Results The study achieved a 40% successful follow‐up rate at 3 months post‐surgery. Among the 500 older adult patients, 131 (26.2%) reported falls before undergoing cataract surgery. Of the 200 patients who had 24.0% falls pre‐operatively, the prevalence of falls 3 months after surgical intervention was 16%. Demographics were not significantly associated with the risk of falling before cataract surgery (p > 0.05). However, participants with chronic conditions were 2.18 times more likely to fall than those without chronic conditions. Patients with hypertension (2.23 times) and diabetes (2.49 times) had higher risk of fall compared to those without these conditions. Additionally, patients with retinal conditions (2.86 times), and those with balance problems (1.86 times) were more prone to falling before surgical intervention than their counterparts without. Conclusion The study highlights the significant impact of cataract surgery in reducing fall prevalence among older adults.

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A 60‐year‐old man with melanoma in situ excised by dermatologist. The patient declined paramedian forehead flap and thus the lesion was repaired using a full thickness skin graft which was harvested from the left supraclavicular region and bolstered in place.
A 65‐year old man with exophytic left malar SCC. Wide local excision performed involved lower eyelid. Cervicofacial advancement flap and tarsal strip procedure performed with excellent cosmesis.
Merkel cell carcinoma of the tip of the nose. Source: Wollina U, Langer D, Tchernev G. Mushroom‐Like Skin Tumors: Report of Three Cases, Open Access Maced J Med Sci. 2017 Jul 21; 5(4):515–517. Reprinted with permission under CC‐BY‐NC license 4.0.
Shave biopsy of skin displaying a Merkel cell carcinoma with pure neuroendocrine morphology at scanning, (a) and high, (b) magnification. The neoplastic small blue round cells exhibit spotty nuclear positivity for Merkel cell polyomavirus, (c) and cytoplasmic positivity for CK20 (paranuclear dot and circumferential patterns), (d) synaptophysin (diffuse cytoplasmic pattern), (e) and neurofilament (scant dot‐like pattern), (f). Source: Walsh NM, Cerroni L. Merkel cell carcinoma: A review. J Cutan Pathol. 2021, Mar; 48(3):411–421. Reprinted with permission under license number 5601670806482.
A 51‐year old man with right nasal side wall basal cell carcinoma 1.2 cm in size. Under went excision and reconstruction using a right melolabial flap. The flap was divided 3 weeks after inset and debulked with favorable cosmetic outcomes.

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Benign and malignant cutaneous nasal lesions

October 2024

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205 Reads

Aims and scope


Eye & ENT Research, an open access ophthalmology journal and otolaryngology journal, provides a platform for cutting-edge research in vision, hearing, and related human diseases. Our interdisciplinary approach combines biochemistry, genetics, and advanced therapeutics to advance the field. We welcome fundamental discoveries, translational research, and clinical insights, fostering progress in ophthalmology and otolaryngology. Embracing diverse disciplines such as biophysics, cellular biology, stem cell biology, and more, we invite you to contribute to the ever-evolving world of Eye & ENT Research.

Recent articles


Cataract blindness related falls among older adults: A prospective cohort study in Ghana
  • Article
  • Full-text available

December 2024

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35 Reads

Background Cataract, the leading cause of blindness worldwide, can significantly impair visual function. Purpose This study investigated the association between cataract‐related falls among the elderly population in the Central region of Ghana. Methods The prospective cohort study among cataract patients aged 65 years and older, using purposive sampling to select facilities and consecutive sampling to recruit participants. Results The study achieved a 40% successful follow‐up rate at 3 months post‐surgery. Among the 500 older adult patients, 131 (26.2%) reported falls before undergoing cataract surgery. Of the 200 patients who had 24.0% falls pre‐operatively, the prevalence of falls 3 months after surgical intervention was 16%. Demographics were not significantly associated with the risk of falling before cataract surgery (p > 0.05). However, participants with chronic conditions were 2.18 times more likely to fall than those without chronic conditions. Patients with hypertension (2.23 times) and diabetes (2.49 times) had higher risk of fall compared to those without these conditions. Additionally, patients with retinal conditions (2.86 times), and those with balance problems (1.86 times) were more prone to falling before surgical intervention than their counterparts without. Conclusion The study highlights the significant impact of cataract surgery in reducing fall prevalence among older adults.


(A) Schematic and (B) computed tomography reconstructed 3D models of sinonasal anatomy developed for use in this app.
(A) Still image of the app's Explore Mode with the middle turbinate highlighted in the schematic model (upper‐left panel), CT reconstructed model (lower‐left panel), and 2D CT images (right panel). Note the yellow plane in the CT reconstructed model (lower‐left panel) designating the anterior‐posterior location of the currently displayed coronal 2D CT image. (B) Still image of the app's Clinical Mode showing a video of a maxillary antrostomy (lower‐left panel). Note how the schematic model (upper‐left panel) is limited to the same view as the intraoperative video to allow trainees to correlate structures. CT, computed tomography.
Improving the educational accessibility of sinonasal and skull base anatomy: A novel virtual tool for otolaryngology trainees

December 2024

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10 Reads

Background Understanding the complex three‐dimensional (3D) anatomy of the nasal cavity, paranasal sinuses, and skull base, is difficult but essential for otolaryngology trainees, especially for endoscopic techniques. There is no effective teaching tool at the junior resident or medical student level allowing visualization and manipulation of these structures in 3D. Objective To create an interactive 3D app modeling the sinus and skull base for use by junior trainees learning surgical anatomy. Methods Using Adobe Photoshop, Cinema 4D, and ZBrush, surgeon and medical illustration teams collaborated to develop a tool combining schematic representation of relevant anatomy with radiologic and endoscopic correlates. This was then incorporated into a web application. Twenty‐one junior residents and medical students were recruited to use the app, and pre‐and post‐app self‐assessments and experience surveys were conducted to assess didactic efficacy. Results We created an online‐compatible fully manipulatable schematic 3D representation of the nasal cavity, paranasal sinuses, and anterior skull base that is capable of anatomic layering. This schematic is presented alongside representative de‐identified radiologic images and surgical principles with corresponding highlighted diagrammatic structures to demonstrate clinically relevant radiologic and endoscopic anatomy. There was a statistically significant improvement in anatomical knowledge in all 13 questions assessing didactic efficacy, with 85.7% of participants providing overall positive feedback. Conclusions Acknowledging the didactic utility in an early validation study with junior trainees, this sinus anatomy teaching tool offers a low‐cost and highly accessible modality capable of demonstrating complex anatomical relationships to trainees learning sinus and endoscopic endonasal skull base surgery.


Gene therapy approaches. Therapies based on gene expression can be characterized as viral and non‐viral methods (left). Schematic representation of mechanisms of RNAi (top middle) and antisense therapy (bottom middle). Modes of action for different CRISPR‐based gene editing (right) (created with BioRender.com).
Gene therapy: New and future treatments for uveitis

December 2024

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15 Reads

Uveitis, characterized by intraocular inflammation, has significant management challenges due to its diverse etiologies and complicated pathophysiology. The current first‐line treatments primarily aim to calm inflammation with the underlying causes unaffected, often associated with systemic side effects, limited long‐term efficacy, and disease recurrence. Gene therapies, as powerful therapeutic approaches, have been applied to treat various genetic and non‐genetic diseases. However, the development of gene therapy for uveitis has been investigated less. This review discusses the possible targets and therapeutic approaches for uveitis gene therapy by analyzing some research examples in exogenous gene expression, RNAi, antisense therapy, and the CRISPR gene editing system. Furthermore, we discuss the limitations of listed gene therapies for uveitis and propose future research directions and potential strategies to overcome current challenges.


Network pharmacology and molecular docking study on the potential mechanism of Tongqiao–Biyan granule in treatment of allergic rhinitis

November 2024

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5 Reads

Purpose Allergic rhinitis (AR) is a pervasive global health problem, imposing a major economic burden and causing disability worldwide. Tongqiao–Biyan granule (TBG) has gained popularity in China for the treatment of AR. This study aimed to elucidate the molecular mechanism underlying TBG's efficacy in treating AR. Methods The Traditional Chinese Medicine pharmacological database was utilized to identify the main ingredients in TBG and their corresponding target genes. AR‐related target genes were identified using the GeneCards, OMIM, and DrugBank databases. The Gene Ontology (GO) network, Kyoto Encyclopedia of Genes and Genomes (KEGG), and target protein–protein interaction (PPI) network were employed to analyze the molecular mechanisms. The top five hub genes were selected for molecular docking with the top five ranked compounds to confirm their interaction in TBG when used in the treatment of AR. Results A total of 7 active ingredients from TBG, 784 predicted targets of TBG, and 945 AR targets were obtained. Analysis via the GO and KEGG databases revealed that TBG can act on AR by modulating inflammatory responses and promoting cell migration. PPI network analysis and molecular docking results suggested that phellopterin, quercetin, luteolin, denudatin B, and cleomiscosin A in TBG may alleviate the AR symptoms by interacting with key proteins such as TNF, AKT1, STAT3, VEGFA, and EGFR. Conclusions TBG modulates numerous targets across diverse signaling pathways in the AR therapy. Our results furnish a theoretical foundation for further exploring TBG's pharmacological mechanism in AR treatment.



Pictures preoperative (A), intraoperative (B–G) and result (H,I) for the nasolabial‐folded‐flap with conchal cartilage.
Aesthetic and functional outcomes in full thickness nasal alar reconstruction: Insights from patients on conchal cartilage and nasolabial‐folded‐flap

October 2024

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15 Reads

Introduction Nasal alar defects pose significant challenges due to the nose's central role in facial aesthetics and function. Various causes, including skin cancer resection, necessitate effective reconstruction techniques. Despite several available methods, identifying an ideal approach remains elusive. Methods This study introduces a single‐stage reconstruction technique employing the nasolabial‐folded‐flap (NFL) with conchal cartilage support. A structured patient questionnaire evaluated functional and aesthetic outcomes, pain, healing and satisfaction. The survey involved six patients who underwent nasal reconstruction using this approach in 12 months. Results Patients expressed high satisfaction with functional and aesthetic outcomes. Functional aspects received very satisfactory ratings (mean 1.7), with aesthetically appealing results (mean 2). Reconstructed noses harmonized well with patients' faces (mean 2), with a moderate impact on daily activities (mean 2.7). Mild pain was occasionally reported (median 2.2) and healing was perceived as very successful (median 1.5). Patients were highly satisfied with care and support (median 1) and felt adequately informed (median 1.5). They strongly recommended this reconstruction technique to others (median 1). Discussion The NFL with conchal cartilage support proves versatile and cosmetically pleasing in single‐stage reconstruction for full‐thickness nasal alar defects. Patients demonstrated a strong willingness to recommend this approach to individuals with similar defects, showcasing its potential advantages. Despite limitations, our findings underscore the prospects of this technique in nasal reconstruction.


Benign and malignant cutaneous nasal lesions

October 2024

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205 Reads

The nose is a structure of both cosmetic and functional importance. Cutaneous lesions of the nose occasionally represent a diagnostic challenge and involve the expertise of several specialties from dermatology, otolaryngology—head and neck surgery, infectious disease, and pathology, among others. We present a review of salient features of malignant and benign cutaneous nasal lesions which are of importance to physicians treating these complicated pathologies.


The computed tomography revealed that the soft tissue (EACC) was confined to the posterior wall of the left external auditory canal and the mastoid cavity on axial plane. The red arrow pointed at the EACC (external auditory canal cholesteatoma).
The computed tomography revealed that the soft tissue (EACC) was confined to the posterior wall of the left external auditory canal and the mastoid cavity on the coronary plane. The red arrow pointed at the EACC.
Under the microscope, the bony defect could be observed within the posterior wall of the external auditory canal. The yellow circle showed the bony defect.
Under the microscope, the posterior wall of the external auditory canal was repaired with autologous mastoid cortical bony powder. The yellow circle showed the bony powder.
Under the microscope, the posterior wall of the external auditory canal was covered with fascia on the plane of the bony powder. The yellow circle showed the fascia.
The optimal surgical treatment for canal‐wall‐up mastoidectomy of external auditory canal cholesteatoma

October 2024

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39 Reads

Purpose To explore the optimal surgical excision treatment for external auditory canal (EAC) cholesteatoma involving the posterior wall and partial mastoid process. Methods This study included 115 inpatients (152 ears) diagnosed with EAC cholesteatoma involving posterior wall and partial mastoid from April 2022 to April 2024. Each patient underwent a canal‐wall‐up mastoidectomy, canaloplasty, and tympanoplasty. Preoperative clinical symptoms and hearing were compared with postoperative outcomes during follow‐ups. Results All patients achieved a dry‐ear status and remained relapse‐free over the 0.5–2 years' follow‐ups. The most salient improvements were observed in hearing loss, oltagia, and aural fullness after the surgical intervention. Conclusion For EAC cholesteatoma with the posterior canal wall and partial mastoid invasion, canal‐wall‐up mastoidectomy with reconstruction of the posterior canal wall is preferable, provided there are no severely extensive cholesteatomas present in the mastoid.


The length of airway obstruction (F = 26.028, p = 0.000) among different mechanical load groups. Low mechanical load group: 1.0 ± 0.6 cm; median mechanical load group: 1.6 ± 0.3 cm; high mechanical load group: 2.8 ± 0.6 cm.
Comparison of the compliance of anteroposterior diameter in the level of the hard palate between groups. Low mechanical load group: 0.4 ± 0.2 mm/cmH2O; median mechanical load group: 0.2 ± 0.1 mm/cmH2O; high mechanical load group: 0.2 ± 0.1 mm/cmH2O.
Effect of pharyngeal wall compliance on passive collapsibility of retropalatal airway in patients with obstructive sleep apnea

January 2024

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21 Reads

Objective To evaluate the pharyngeal compliance of patients with obstructive sleep apnea with complete muscle relaxation. And to study the relationship between the pharyngeal wall compliance and the mechanical load of the retropalatal airway. Methods The static mechanical load of the retropalatal pharynx was determined by critical closing pressure (Pcrit) of the segment during general anesthesia in 30 patients. The size/dimensions of the pharynx were measured while intraluminal pressure was controlled at 3–20 cmH2O. Results A total of 30 participants (age: 37.6 ± 7.6 years, 27 males) were studied. The mean apnea‐hypopnea index was 51.6 ± 23.9 events/h. The retropalatal mean Pcrit was 12.68 ± 4.13 cmH2O. There was a significant difference in the length of the obstruction segment (F = 26.028, p < 0.001) among groups with different pharyngeal collapsibility. The correlation between the mechanical load of retropalatal airway and pharyngeal compliance in the level of the hard palate (r = −0.448, p = 0.015) and the uvula level (r = −0.462, p = 0.026) were significant. Conclusions Increased retropalatal mechanical loads were related to abnormal passive compliance of the pharyngeal wall. The contribution of each pharyngeal wall to airway collapse was varied.


Relationship between gender and age of 350 patients with parotid gland tumor.
The relationship between benign and malignant and age in 350 patients with parotid gland tumor.
Sites of parotid gland tumor in 350 cases.
Constituent ratio of depth in 350 patients with parotid gland tumors.
A retrospective analysis of 350 cases of parotid gland tumors and the value of ultrasound in the diagnosis of benign and malignant parotid gland tumors

January 2024

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31 Reads

Objective To retrospective analysis of the epidemiological and clinical characteristics of parotid gland tumors, and to explore the value of ultrasound in the differentiation of benign and malignant parotid gland tumors. Methods The clinical data of 350 patients with parotid gland tumors in our hospital from 2002 to 2022 were retrospectively analyzed. These patients were examined by ultrasound. The postoperative pathological test results were used as the “gold standard” to verify and analyze the value of color Doppler ultrasound in the differential diagnosis of benign and malignant parotid tumors (PT). Results The male‐to‐female ratio of 350 patients with parotid gland tumors was 1.16:1. The age of patients ranged from 12 to 87 years old. Patients aged 40–65 years accounted for 54.6%, which was the most common age of parotid gland tumors. Among 350 cases, 259 were benign and 91 were malignant. The top three benign PTs were pleomorphic adenoma, Warthin tumor, and basal cell adenoma. The top three malignant tumors were mucoepidermoid carcinoma, acinar cell carcinoma, and adenoid cystic carcinoma. The specificity, sensitivity, accuracy, positive predictive value, and negative predictive value of ultrasonography in the diagnosis of benign and malignant parotid masses were 96.53%, 69.23%, 89.43%, 87.50%, and 87.72%, respectively. Conclusion The pathological types of parotid gland tumors are complex and diverse. Ultrasonography has high accuracy in the diagnosis of PT, which can provide important evidence for the differentiation of benign and malignant PT, and then assist in the clinical selection of individualized surgical programs.


Immunopathogenesis of IL‐4/IL‐13 signaling pathways and targeted biologics. The binding of IL‐4 and/or IL‐13 with type I or type II receptor, leads to activation of intracellular signaling molecules such as STAT6 and IRS‐2, followed by activation of target gene transcription. IL‐4 and IL‐13 receptors are widely expressed on most cell types, which leads to various pathological changes in different cells, contributing to the pathogenesis of type 2 inflammation. ALOX15, arachidonate 15‐lipoxygenase; CCL26, C‐C Motif Chemokine Ligand 26; DSG1, desmoglein 1; ERK1/2, extracellular signal‐regulated kinase 1/2; FLG, filaggrin; HDAC, histone deacetylase; IRF4, interferon regulatory factor 4; IRS‐2, insulin receptor substrate 2; JAK, janus tyrosine kinases; KLF4, krueppel‐like factor 4; mTOR, mechanistic target of rapamycin; MUC5AC, mucin 5AC; PDK, pyruvate dehydrogenase kinase; PI3K, phosphoinositide 3‐kinase; PIP‐3, phosphatidylinositol‐3‐phosphate; STAT6, signal transducer and activator of transcription 6; Tyk, tyrosine kinase; VCAM, vascular cell adhesion molecule; YAP, yes associated transcriptional regulator. Figure was created with BioRender.com.
IL‐4/IL‐13 pathway in nasal type 2 inflammation: The central role and targeted therapy

January 2024

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59 Reads

Type 2 dominant inflammation in nasal mucosa is the key underlying pathophysiological mechanism of allergic rhinitis (AR) and most presentations of chronic rhinosinusitis with nasal polyps (CRSwNP). Interleukin‐4 (IL‐4) and IL‐13 share common receptor subunits and signaling molecules, which lead to various pathological changes in different cells, playing key roles in the pathogenesis of nasal type 2 inflammation. Numerous clinical trials have shown that biologics targeting key molecules of the IL‐4/IL‐13 pathway, especially IL‐4 receptor alpha, can treat CRSwNP and AR with high efficacy, and are generally well tolerated. Several biologics have been approved for the treatment of difficult‐to‐control CRSwNP, while others also show promising results. Here, we review the IL‐4/IL‐13 pathway, its role in nasal type 2 inflammation, and current targeted therapies related to the IL‐4/IL‐13 pathway, with a focus on AR and CRSwNP.


Diagram of the “Dual‐Pressure Theory”. Left: the physiological condition of TLCPD formed by IOP and ICP (yellow arrows). Right: Lower ICP could lead to TLCPD elevation, which is the essential risk factor for the progression of glaucoma. Dual pressure = IOP versus ICP. IOP, intraocular pressure; ICP, intracranial pressure; TLCPD, translaminar cribrosa pressure difference. Reprinted with permission from [77].
Oblique magnetic resonance coronal T2WI‐FRFSE slices perpendicular to the optic nerve at 3, 9, and 15 mm behind the globe with fat suppression were captured to visualize the optic nerve sheath complex, shown as a faint white circular ring in the center of the image. Reprinted with permission from [78].
“Dual‐pressure theory” in pathogenesis of glaucomatous optic neuropathy from the Beijing intracranial and intraocular pressure study

January 2024

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93 Reads

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1 Citation

The mechanical theory of glaucoma indicates that high intraocular pressure (IOP) leads to glaucomatous optic nerve damage. However, nearly half of primary open‐angle glaucoma patients with normal intraocular pressure also exhibit progression of what appears to be glaucomatous optic nerve damage. Our earlier prospective study identified for the first time that the relatively low intracranial pressure (ICP) is also an important risk factor for progressive glaucomatous injury of normal‐tension glaucoma. When considering the results of studies in nonhuman primates, clinical research, large‐scale natural‐population studies, and basic laboratory investigations, a new understanding of the pathophysiology of glaucoma, the “Dual‐Pressure Theory”, has been proposed. This theory states that “either high IOP or low ICP contributes to increasing the translaminar cribrosa pressure difference; it is the pressure difference rather than the IOP alone that results in the glaucomatous optic neuropathy”. Here, we provide a systematic introduction to Dual‐Pressure Theory relating to glaucoma, the form of a research map, an outline of basic laboratory investigations, the main methodology, and research updates.


The crude number of individuals with blindness and the proportional causes of irreversible blindness in representative regions globally. Different colors represent different causes, and the number of stick figures represents the number of blind individuals in regions. Data from Vision Loss Expert Group of the Global Burden of Disease Study (VLEG–GBD)[6,7].
Near future clinical regenerative therapy strategies.
The next‐generation therapies in ophthalmology for blindness worldwide

January 2024

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44 Reads

With the rapid and groundbreaking development in 21st century medicine on a global scale, new possibilities have emerged for addressing eye diseases, that can be blindness, and that conventional pharmaceuticals and surgical interventions have not hitherto been able to adequately treat. Gene enhancement/supplementation, gene editing, and stem cell therapies have now emerged as key subdisciplines. Here we discuss the current state and prospects of regenerative therapy in the field of ophthalmology, with a primary focus on diseases affecting the cornea, retina, and optic nerve. Our review summarizes the latest advances, challenges, and opportunities in these fields, as well as the potential applications and limitations of different strategies. The review also highlights the importance of interdisciplinary and collaborative innovation models for achieving breakthroughs in therapeutic development for sight‐loss diseases worldwide.


Multiple strategies of corneal endothelial regeneration and replacement. ASC, adult stem cells; CECs, corneal endothelial cells; CES, corneal endothelial sheet; EGF, epidermal growth factor; FGF, fibroblast growth factor; hESC, human embryonic stem cells; hiPSC, human induced pluripotent stem cells; PDGF, platelet‐derived growth factor; ROCK, Rho‐associated kinase.
Research progress of corneal endothelial cell regeneration and replacement

January 2024

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52 Reads

Corneal endothelial cells (CECs) are crucial for the maintenance of corneal transparency and normal visual function. Corneal endothelial dysfunction can lead to corneal edema, opacity, and even blindness. Due to the limited proliferative capacity of human CECs and the global shortage of donor cornea, corneal endothelial regeneration and replacement always represent the most challenge in the basic research and clinical treatment of corneal diseases. Although there is a potential existence of corneal endothelial progenitor cells, the efficiency of Descemet stripping without endothelial keratoplasty remains controversial. In recent years, significant advancements have been made in the field of cultured endothelial cell regeneration and artificial material replacement. Here, we reviewed the current research and clinical progress of corneal endothelial cell regeneration and replacement, including the in vitro cultivation of primary human CECs, in vitro differentiation of stem cell‐derived CECs, tissue‐engineered corneal endothelium, and fabrication of artificial corneal endothelium. We also discussed the remaining questions regarding innovating clinical preventive and therapeutic strategies for corneal endothelial dysfunction.


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