Prosthetic Corneal Surgery: A Narrative Review of Current Keratoprostheses and the Future Prospects of New Biomaterials.

Corneal diseases affect a significant proportion of the global population, with younger age groups being particularly vulnerable. In severe cases involving vision loss, standard techniques such as keratoplasty often fail. These cases require more invasive treatment through the implantation of artificial cornea or keratoprostheses. Since the development of the oldest technique for creating and implanting the first keratoprostheses by Strampelli, these devices have experienced major modifications to improve their biocompatibility, function, and long-term viability. As a result, there is currently a wide range of implants and procedures that are available and can be applied according to patient indications and clinical settings. This narrative review attempts to cover the literature on this topic by focusing on (1) recent advances in rigid (Boston Type I and II, osteo-odonto-keratoprosthesis, modified osteo-odonto-keratoprosthesis, and LV Prasad Eye Institute keratoprosthesis) and soft (AlphaCor, CorNeat, and EndoArt) keratoprosthesis designs and (2) more recent studies on innovative biomaterials and techniques that could lead to the fabrication of fully functional biosynthetic corneas with optimal properties. In our review of these materials, we cover the current clinical applications and limitations, as well as future prospects of less invasive and more efficient prostheses that could improve patient outcomes and quality of life.