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Griffith M., Li F., Carlsson D. J., Liu Y., Lohmann C., Beuckert D., Suuronen E.
Corneal diseases currently affect an estimated 10 million individuals worldwide. Substitute corneas are needed to address the current disadvantages of human donor corneas, which include immune rejection and the shortage of donor tissue. Substitutes can be designed to replace part or the full thickness of damaged or diseased corneas. In this review, the advances made to date regarding some of the various strategies employed to develop bioengineered corneas are outlined. These engineered tissues include prosthetic devices such as the AlphaCor™ artificial cornea, which has now received approval for clinical use in a number of countries. Another approach consists of a self-assembling corneal equivalent derived from cell-produced matrix sheets. Yet another technique employs bio-synthetic matrices that are integrated into the cornea to permit host tissue regeneration. For the correction of refractive errors, bioengineered corneal implants, termed lenticules, have been developed as alternatives to refractive surgeries, such as the popular laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) procedures. The desired properties of the materials for all the engineered replacements are the same, and the benefits and limitations of each are discussed.