Synthetic corneal implant shows promise in eyes with chronic corneal oedema

Artificial corneal endothelial implantation produced significant reductions in corneal thickness and improvements in visual acuity in patients with chronic corneal oedema, including those with prior failed endothelial keratoplasty, according to a case series published in Clinical Ophthalmology.¹

Study design and outcomes

Levy and colleagues, of Sussex Eye Hospital at University Hospitals Sussex NHS Foundation Trust in Brighton, UK, conducted a retrospective, noncomparative review of 9 eyes from 9 consecutive patients who underwent implantation of an artificial corneal endothelial implant (EndoArt; EyeYon Medical) between December 2024 and November 2025. Mean patient age was 72 years, and 4 patients (44%) had a history of failed endothelial keratoplasty, including 3 with prior DMEK and 1 with prior DSAEK. Eyes with prior penetrating keratoplasty were excluded.¹

The primary outcome was central corneal thickness (CCT), measured by anterior segment optical coherence tomography. After accounting for the 50-µm thickness of the implant itself, corneal thickness fell by roughly a third, from a baseline average of 780 µm to 574 µm postoperatively (P = .01). Mean best-corrected distance visual acuity improved from 2.28 to 1.16 logMAR, with 3 patients (33%) achieving a postoperative result of 0.5 logMAR or better.¹

Safety profile and reintervention

Two patients (22%) required re-suturing because of suboptimal implant positioning or partial detachment; none needed a rebubbling procedure. The authors noted that both of these patients shared a common surgical history of prior vitrectomy without capsular support, a combination that limited their capacity for effective gas tamponade and appeared to predispose them to attachment problems. No cases of endophthalmitis, inflammatory reactions or chronic intraocular pressure elevation were observed during follow-up.¹

The authors noted that their reintervention rate was lower than that reported in a recent systematic review, which found a rebubbling rate of nearly 48%. They attributed this difference, in part, to their technique of placing multiple transfixing sutures in eyes with compromised gas tamponade capacity.¹

Clinical implications

The authors concluded that artificial corneal endothelial implantation represents a viable donor-tissue-independent alternative for patients in whom traditional keratoplasty carries a guarded prognosis, including those with prior graft failure or glaucoma drainage devices. They noted that visual outcomes, while meaningful, remained more modest than those typically achieved with conventional Descemet membrane endothelial keratoplasty, a difference they attributed largely to coexisting ocular comorbidities among study patients rather than to the implant itself.¹

The study's retrospective design, small sample size and absence of a control group were cited as limitations, alongside the need for larger prospective studies to establish clearer patient selection criteria.¹

The study received open-access funding support from EyeYon Medical. The sponsor had no role in study design, data analysis, interpretation of results or manuscript preparation.²

References

1. Levy I, Mukhija R, Nanavaty MA. Outcomes of synthetic corneal endothelial implant in patients with corneal oedema with or without prior endothelial keratoplasty: a case series. Clin Ophthalmol. 2026;20:604707. doi:10.2147/OPTH.S604707

2. Romano D, Ventura M, Vaccaro S, et al. Corneal artificial endothelial layer (EndoArt): literature review and our experience. J Clin Med. 2024;13(21):6520. doi:10.3390/jcm13216520