EndoArt Scientific Publications Hub

All 28 EndoArt publications

2026

EndoArt in Corneal Endothelial Disease: Systematic Review and Meta-Analysis of Clinical Outcomes and Complications

Muneeb A. KhanCureus
Systematic review of 12 studies (68 eyes). Meta-analysis confirmed meaningful deturgescence and modest visual gains. However, high rates of detachment and rebubbling (pooled rebubbling rate 60.2%, 4 studies) were observed. Concludes EndoArt is best viewed as salvage therapy for high-risk eyes.

Muneeb A. Khan, Diya Baker, Mohammad Karam, Afaq Khan, Narvair Kahlar, Abdulmalik Alsaif

Review68 patientsOtherOverlapping cohort
2026

Scanning electron microscopy of artificial corneal endothelial keratoplasty implant

Mayank A. NanavatyJournal of Cataract & Refractive Surgery
Environmental scanning electron microscopy of 3 EndoArt specimens (2 fresh, 1 explanted) at the University of Brighton. Both surfaces were exceptionally smooth with a tapered edge profile, and surface quality exceeded that typically seen in conventional hydrophilic acrylic intraocular lenses. The explanted specimen showed morphology similar to fresh specimens, with fibers attached to the corneal-facing surface. The authors relate the smoothness and edge profile to the device's barrier function and to published corneal thickness reductions of 18% to 37%, and conclude that the morphology supports EndoArt's role as a viable alternative to biological endothelial keratoplasty in complex cases, citing published clinical studies; the study itself reports no clinical outcome data. Funded by EyeYon Medical.

Mayank A. Nanavaty, MBBS, DO, FRCOphth, PhD, Issac Levy, MD, Paria Akbari, MD-MPH, Martin Smith, BSc, PhD

Laboratory3 patientsOther
2026

Outcomes of Synthetic Corneal Endothelial Implant in Patients with Corneal Oedema with or without Prior Endothelial Keratoplasty: A Case Series

Issac LevyClinical Ophthalmology
Retrospective case series of 9 eyes (4 with prior failed endothelial keratoplasty) undergoing EndoArt implantation for chronic corneal oedema at a UK tertiary centre. At last follow-up (mean 27 weeks), mean CCT fell 35% (780 to 574 µm after subtracting the 50 µm implant thickness, p=0.01) and BCDVA improved from 2.28 to 1.16 logMAR. Two patients (22%) required re-suturing, none required rebubbling, and two eyes remained only partially attached at last follow-up under observation. The authors conclude the procedure was feasible in complex eyes (prior failed EK, glaucoma drainage devices, vitrectomy) with an acceptable safety profile, supporting EndoArt as a donor-tissue-independent alternative for high-risk patients.

Issac Levy1-3, Ritika Mukhija1, Mayank A Nanavaty1,2

Clinical study9 patients1 year or less
2026

PK-SMART: Penetrating Keratoplasty With Sutureless Membrane Artificial Endothelial Replacement Technique. Report of the First Three Clinical Cases

Luigi FontanaCornea
PK-SMART is a novel surgical technique combining penetrating keratoplasty with sutureless EndoArt implantation by embedding the device within a donor stromal lamellar pocket before transplantation. In three high-risk eyes with failed PK and complex anterior segment anatomy, all grafts were centrally clear with complete device adhesion at 6 months, CCT decreased in every eye (803 to 578 µm, 975 to 587 µm, 761 to 548 µm) and CDVA improved (LP to HM, HM to 20/400, HM to 20/100), with no postoperative complications or device detachment. The authors suggest the approach may eliminate the need for transcorneal sutures, gas tamponade, and postoperative posturing; larger studies with longer follow-up are needed.

Luigi Fontana, MD, PhD,*† Vito Romano, MD,‡ Natalie di Geronimo, MD,*† Piera Versura, BSD,*† Maurizio Mete, MD,*† and Antonio Moramarco, MD*†§

Clinical study3 patients1 year or less
2026

EndoArt: Indications, Mechanism of Action, Outcomes, and Complications

Björn O. BachmannKlinische Monatsblätter für Augenheilkunde
Overview article from the University of Cologne summarizing the indications, mechanism of action, surgical technique, clinical outcomes, and complications of the EndoArt artificial endothelial keratoprosthesis. It synthesizes published case series (Daphna, Romano, Fitoussi, Wiedemann, Fontana, Lapid-Gortzak) together with the authors' own high-risk cohort of more than 70 eyes, the largest group being glaucoma patients after glaucoma surgery, in whom the risk of early DMEK failure is particularly high (especially with a glaucoma drainage device). The authors report modest visual gain and corneal dehydration in eyes with limited visual potential, alongside a broad complication spectrum that may necessitate explantation.

Björn O. Bachmann, Simona Schlereth, Mert Mestanoglu, Claus Cursiefen, Johanna Wiedemann

Review70 patientsOtherOverlapping cohort
2025

4.5-Year Follow-up with a Novel Corneal Endothelial Prosthesis

Ruth Lapid-GortzakKlinische Monatsblätter für Augenheilkunde
Single-centre series of 10 eyes followed for up to 4.5 years (7 from the first-in-human trial). The device stayed adherent in 9 of 10 eyes, mean CCT fell from 927 to 621 µm and visual acuity improved in 6 of 10 eyes (Table 3 values show improvement in 7 of 10), with no device-related adverse events or pathological thinning; good functional vision was not reached because of the complex initial pathology. Rebubbling rates were high before suturing was introduced, and adherence failed on the irregular posterior surface of an eye with repeated PKP. The authors see EndoArt as an additional option for repeat graft failure, or a primary procedure where donor tissue is unavailable, and call for longer follow-up and larger cohorts.

Ruth Lapid-Gortzak , Ivanka van der Meulen

Clinical study10 patientsMore than 1 YearOverlapping cohort
2025

Long-Term Clinical Outcomes and Anterior Segment Optical Coherence Tomography Findings After Artificial Endothelial Replacement Membrane Implantation

Luigi FontanaCornea
Retrospective series of 7 eyes with chronic corneal edema and a limited prognosis for EK (5 late EK failures, 2 bullous keratopathy) followed for 24 months. CCT fell from 805 to 577 µm (p=0.002) and CDVA improved from 1.32 to 0.95 logMAR (p=0.03) (Table 1 final values average 0.77 logMAR). All implants were retained and stably attached from 6 months on, although 4 of 7 detached in the first months and needed 6 rebubblings. AS-OCT showed a hyperreflective band, possibly fibrous tissue, between the implant edge and the posterior stroma in all 7 (complete in 5, partial in 2; the abstract says most patients), which the authors suggest may explain the stable adhesion. The 2 eyes fixed with 3 reversed Y-shaped sutures did not detach; the authors propose that multiple sutures may enhance stability, pending larger studies.

Luigi Fontana, MD, PhD,*† Natalie di Geronimo, MD,*† Piera Versura, BSD,*† and Antonio Moramarco, MD*†

Clinical study7 patientsMore than 1 YearOverlapping cohort
2025

Influence of Posterior Corneal Surface Irregularities on the Attachment of an Artificial Endothelial Layer (EndoART)

Ruth DonnerJournal of Clinical Medicine
Case series of 11 eyes after multiple prior surgeries, assessing whether posterior corneal irregularity affects EndoART adhesion. The implant adhered in 9 of 11 eyes, including eyes with moderate irregularity (posterior elevation difference up to 204 µm) and an eye with a glaucoma shunt; the 2 eyes with highly irregular surfaces (407 and 414 µm) never adhered and needed biological grafts. Re-bubbling was needed in 36%; pachymetry and ACD showed no clear relation to failure. Patients reported less pain and photophobia with modest visual gains; the authors note the small sample prevents a precise irregularity cut-off.

Ruth Donner * , Michal Klimek and Gerald Schmidinger

Clinical study11 patients1 year or lessOverlapping cohort
2025

Spontaneous Artificial Corneal Endothelial Graft Reattachment: Case Report

Nicole MechlebCornea
First report of spontaneous EndoArt reattachment. Both patients had partial detachment from day 1 that persisted after rebubbling (once with air in case 1; twice with SF6 plus an extra suture in case 2). Further intervention was then not pursued, and both implants reattached spontaneously, by day 16 and week 6, with corneal thinning on serial AS-OCT, stable at 6 to 8 months. Case 2 is now scheduled for combined cataract extraction with toric IOL implantation and DMEK. The authors conclude that observation may be a viable option in select cases, although rebubbling remains standard practice. (The abstract states that rebubbling was considered but a conservative approach was taken.)

Mechleb Nicole, MD,*† Gatinel Damien, MD, PhD,*† and Saad Alain, MD*†

Case report2 patients1 year or less
2025

Atypical Endophthalmitis Following Artificial Corneal Endothelial Implantation

Beatrice CesaroCornea
First reported case of endophthalmitis after EndoArt implantation, although the authors state a direct causal link remains uncertain. A 75-year-old woman presented 7 months after implantation, 6 weeks after suture removal, with painless floaters; the infection was first taken for vitreous hemorrhage and progressed within a day. Prompt vitrectomy with intravitreal antibiotics and heavy silicone oil, retaining the EndoArt, followed by local and systemic antibiotics, resolved the Staphylococcus epidermidis infection; BCVA at 2 months was 20/400 (hand motion at its worst, 20/63 before the infection), with mild diffuse corneal edema and limited superonasal and inferior EndoArt detachment. The authors suggest the retained implant may have helped preserve corneal clarity for vitrectomy, and stress vigilance and an individualized approach in complex postkeratoplasty eyes.

Beatrice Cesaro, MD,* Mariantonia Ferrara, MD,*† Francesco Morescalchi, MD,*† Nicola Bergamaschi, MD,* Federico Gandolfo, MD,† Francesco Semeraro, MD,*† and Vito Romano, MD*†

Case report1 patient1 year or lessOverlapping cohort
2025

Long-Term Observations of the First Human Implantation of an Artificial Endothelial Layer for Endothelial Dysfunction: A Pilot Study

Gerd U. AuffarthCornea
Retrospective pilot series of the first human EndoArt implantations: 5 eyes of 5 patients (3 PBK; 2 FECD treated as a primary procedure because the patients declined donor tissue), mean follow-up 38.4 months (up to 6 years). Mean CCT fell from 741.2 to 558.4 µm (p<0.001; Table 2 individual values average 761.2 µm preoperatively and 546.8 µm at the last measurement); mean CDVA improved from 1.5 to 1.1 logMAR, not significantly (p=0.19). No serious implant-related adverse events were observed, but rebubbling was frequent (mean 2.8 per eye), and 1 eye underwent PKP at 31 months for preexisting subepithelial fibrosis; its histology showed a thin fibrocellular membrane covering the posterior implant surface, which the authors hypothesize may aid adherence. The authors urge caution given the small sample.

Hyeck-Soo Son, MD,* Victor A. Augustin, MD,* Charles G. Eberhart, MD, PhD,† Maximilian Friedrich, MD,* Emanuel Reitemeyer, MD,* Nikola Henningsen, MD,* Oliver Hassel, MD,* Louise Blöck, MD,* and Gerd U. Auffarth, MD*

Clinical study5 patientsMore than 1 YearOverlapping cohort
2025

Corneal Artificial Endothelial Layer (EndoArt) in Outpatients: Outcomes From a Case Series

Léa FitoussiCornea
Retrospective series of 15 eyes, described by the authors as the largest retrospective cohort to date, all implanted as outpatient procedures, which did not appear to compromise outcomes. Mean CCT fell by 28% (844 to 607 µm at 6 months) and BCVA improved significantly but modestly (2.13 to 1.84 logMAR at final follow-up), remaining in the range of severe visual impairment. (The abstract reports the 607 µm value at the last visit, 1 to 6 months; Table 1 shows 5 of 15 eyes followed to 6 months.) Rebubbling was needed in 66.7% of eyes and IOP rose in 33%, with 2 explantations, 1 intraoperative dislocation and 1 retinal detachment. The authors conclude EndoArt may represent a therapeutic option in complex eyes and call for careful patient selection and randomized trials against repeat DMEK or DSAEK.

Léa Fitoussi, MD, Christophe Panthier, MD, Nicole Mechleb, MD, Damien Gatinel, MD, PhD, and Alain Saad, MD

Clinical study15 patients1 year or less
2025

Late Dehiscence After Initial Successful EndoArt Implantation

O. ArdeleanCornea
Case report of a 73-year-old man with 3 failed DMEK whose EndoArt, well attached with visual improvement (up to 0.4 decimal) after implantation, dehisced superiorly 10 months later. Rebubbling with 20% SF6 without extra sutures reattached the implant, but vision remained poor (0.1 decimal) with peripheral edema. The authors conclude late dehiscence can occur beyond the usual first 3 months, that late rebubbling is feasible, and that extended follow-up is needed, particularly in complex eyes.

O. Ardelean, MD, G. Geerling, FEBO, and M. Borrelli, FEBO

Case report1 patient1 year or less
2025

Management and Histological Analysis of a Retroprosthetic Membrane as a Novel Complication After EndoArt Implantation

Johanna WiedemannCornea
First report of retroprosthetic membrane (RPM) formation behind EndoArt: 3 of 69 implanted eyes (4.35%) developed an RPM a mean of 7.3 months after implantation, all high-risk eyes with 2 to 3 failed DMEKs. BCVA varied (median 1.7 logMAR before implantation, 2.2 after RPM development). One eye underwent membranectomy, which improved corneal transparency with the implant attached, but the membrane recurred 2 months later; the RPM of another eye had not yet been treated. Histology of the one excised membrane showed type III collagen, vimentin-positive and CD68-positive cells without myofibroblasts, which the authors interpret as a primarily reparative, chronic remodeling process with a low-grade inflammatory profile, without excluding minor acute inflammatory activity (the abstract states the findings suggest chronic remodeling without acute inflammation). The authors describe RPM as rare and suggest it may result from chronic blood-aqueous barrier breakdown.

Schenny Murra, MD,*† Johanna Wiedemann, MD,† Simona Schlereth, MD,† Claus Cursiefen, MD,† and Björn Bachmann, MD†

Clinical study3 patientsOtherOverlapping cohort
2024

Artificial Endothelial Layer Implantation After Multiple Failed Keratoplasties

Jasmien RensCornea
First report of EndoArt after penetrating keratoplasty, in an eye with 3 prior graft rejections. The implant stayed attached for 12 months and CCT fell from 1005 to 661 µm, with limited visual gain (0.13 decimal Snellen) due to glaucomatous optic nerve damage. The authors suggest EndoArt could serve as an alternative to lamellar endothelial keratoplasty where tissue rejection has occurred and is highly likely to recur, noting that longer-term follow-up is required.

Jasmien Rens, MD,*† Iva Krolo, MD,*‡§ Carina Koppen, MD, PhD,*† and Sorcha Ni Dhubhghaill, MBBCh, PhD, FEBOS-CR*†‡§

Case report1 patient1 year or less
2024

A Novel Artificial Endothelial Replacement Membrane for the Treatment of Chronic Corneal Edema

Ofer DaphnaCornea
First-in-human prospective multicenter trial of EndoArt in 24 pseudophakic eyes with chronic corneal edema and low-to-normal visual potential. No device-related serious adverse events were reported; in the 17 eyes completing 12 months, mean CCT fell from 759 to 613 µm, and BCDVA improved from 1.88 to 1.34 logMAR in the 15 assessable eyes, with less pain. Attachment was the main limitation: mean 2.9 rebubblings per patient and 6 of 24 implants (25%) explanted (5 for attachment failure, all without descemetorhexis, 1 procedural failure), prompting a protocol with descemetorhexis, fixation suture and long-acting gas. The authors conclude EndoArt may offer an option where donor corneas are scarce or prognosis with human tissue is poor.

Ofer Daphna, MD,*† Gerd U. Auffarth, MD, PhD,‡ Ruth Lapid-Gortzak, MD, PhD,§ Sunita Chaurasia, MD,¶ Efrat Gilboa, MSc,* Anat Lemze, BSc, MBA,* Michael Dover, MD,* and Arie L. Marcovich, MD, PhD*║

Clinical study24 patients1 year or lessOverlapping cohort
2024

Künstlicher Endothelersatz bei bullöser Keratopathie: Ergebnisse einer neuen Therapieoption (Artificial endothelium to treat bullous keratopathy: results of a new surgical treatment option)

Gerald SchmidingerZeitschrift für praktische Augenheilkunde & augenärztliche Fortbildung
First 10 eyes treated with EndoArt at the Vienna University Eye Clinic, all with bullous keratopathy, multiple previous surgeries and high risk of graft failure. Median central corneal thickness fell by about 30% within 2 months; the authors report successful implant attachment in a large proportion of patients, with approximately physiological thickness and transparency of the central 6.5 mm, and less photophobia in all patients with an attached implant, but visual acuity improved only slightly in most eyes. Rebubbling was needed in 40% of eyes and 2 patients developed microbial keratitis under therapeutic contact lenses. The authors see EndoArt as an option for eyes that cannot be rehabilitated with donor tissue, but caution that long-term results are lacking and broad use in Fuchs endothelial dystrophy with good visual potential should be viewed critically.

GERALD SCHMIDINGER, RUTH DONNER, MICHAEL KLIMEK

Clinical study10 patients1 year or lessOverlapping cohort
2024

Busin Glide-Assisted Pull-Through Insertion of Artificial Corneal Endothelium (EndoArt)

Akira KobayashiInternational Medical Case Reports Journal
Case report of a Busin glide-assisted pull-through technique for inserting EndoArt in an 82-year-old woman with bullous keratopathy after failed DMEK, where corneal haze limited anterior chamber visualization. The implant was inserted smoothly without upside-down attachment; a partial detachment on day 1 resolved after air re-injection, and over the 3-month follow-up CCT fell from 845 to 530 µm (Figure 3 legend reports 753 µm preoperatively), pain resolved and BCVA improved from hand motion to 0.01. The authors suggest the technique may be useful in eyes with repeat surgery or trauma to avoid potential complications such as epithelial implantation cysts or downgrowth.

Akira Kobayashi1, Takahiko Hayashi2, Ami Igarashi2, Toshiki Shimizu2, Hideaki Yokogawa1, Kentaro Yuda3, Björn Bachmann4, Satoru Yamagami2, Kazuhisa Sugiyama1

Case report1 patient1 year or less
2024

Short-term clinical and confocal microscopy changes after synthetic endothelial replacement

L. Fernández-Vega-CuetoJournal français d'ophtalmologie
Clinical image report of a 66-year-old woman with diffuse corneal edema despite an attached DMEK lamella (DMEK performed for endothelial decompensation secondary to pseudoexfoliation glaucoma with prior valve implantation), treated with EndoArt. At 5 months, central corneal thickness had decreased with improved central transparency, and in vivo confocal microscopy showed progressive reduction of edema, with the epithelial layer becoming visible and keratocytes becoming recognizable. The authors consider the device promising for selected cases but state that its safety and efficacy need confirmation in controlled, long-term studies.

L. Fernández-Vega-Cueto, C. Lisa, R. Alvarado-Villacorta*

Case report1 patient1 year or less
2024

Suture Pull-Through Technique for EndoArt Insertion in a Complex Case Scenario

Pratima VishwakarmaCornea Open
Case report of a novel 10-0 prolene suture pull-through technique for inserting EndoArt in a 59-year-old woman whose eye had an open globe injury with aphakia and aniridia, later an artificial iris and scleral-fixated IOL, and 3 failed DMEKs; the technique aims to prevent posterior dislocation of the implant. Insertion succeeded without dislocation; peripheral detachment required 3 rebubblings with augmentation of the anchoring sutures, and at 1.5 months the implant was attached apart from minimal temporal detachment, with CCT 1062 -> 751 µm (apex) and BCVA 1.22 -> 0.8 logMAR. The authors propose the technique for complex cases such as aphakic, aniridic and vitrectomized eyes.

Pratima Vishwakarma, DNB,*† Johanna Wiedemann, MD,* Akira Kobayashi, MD, PhD,‡ Takahiko Hayashi, MD, PhD,§ Simona Schlereth, MD,* Claus Cursiefen, MD, PhD,* and Björn Bachmann, MD, PhD*

Case report1 patient1 year or lessOverlapping cohort
2024

EndoArt®: Ergebnisse bei Patienten mit Glaukom-Drainage-Implantaten (EndoArt®: results in patients with glaucoma drainage devices)

Johanna WiedemannDie Ophthalmologie
Retrospective Cologne series of 12 eyes with glaucoma drainage devices and high risk of graft failure treated with EndoArt. BSCVA improved significantly from 1.6 to 1.1 logMAR at 7 to 12 weeks, and CCT fell from 719 µm (significant at 2 to 6 weeks and at last data entry, not at 7 to 12 weeks), but the rebubbling rate was high and one implant was later explanted for insufficient clearing. The authors conclude EndoArt may be advantageous in high-risk eyes and call for prospective studies with longer follow-up and a DMEK control group.

Johanna Wiedemann · Mert Mestanoglu · Anne Rekate · Caroline Gietzelt · Claus Cursiefen · Björn Bachmann

Clinical study12 patients1 year or lessOverlapping cohort
2024

Corneal Endothelial Keratoprosthesis EndoArt in Patients With Glaucoma at High Risk of Graft Failure After Keratoplasty

Johanna WiedemannCornea
Retrospective Cologne series of 14 consecutive patients with glaucoma at high risk of graft failure after keratoplasty (10 with previous DMEK, 2 of whom also had previous PK, and 4 without previous corneal surgery), treated with EndoArt, with outcomes reported up to 7 to 12 weeks. CCT decreased significantly from 771.8 µm preoperatively to 622.1 µm at 2 to 6 weeks (P = 0.025) and 562.8 µm at 7 to 12 weeks (P = 0.012), while BSCVA (1.6 to 1.3 logMAR at 7 to 12 weeks) did not change significantly at any timepoint; when asked, patients reported less discomfort and improved visual perception (not systematically analyzed), and rebubbling was needed in 8 of 14 eyes (57.1%). The authors describe EndoArt as a feasible procedure for managing persistent graft failure after re-DMEK and suggest that patients at high risk of graft failure may benefit from it. Longer-term prospective studies are needed. (Table 1 lists 5 eyes without previous keratoplasty.)

Johanna Wiedemann, MD, Deniz Hos, MD, PhD, Mert Mestanoglu, MD, Claus Cursiefen, MD, and Björn Bachmann, MD

Clinical study14 patients1 year or lessOverlapping cohort
2024

Corneal Artificial Endothelial Layer (EndoArt): Literature Review and Our Experience

Davide RomanoJournal of Clinical Medicine
Literature review of 23 reported EndoArt eyes, including 2 new cases after multiple failed PK and DSAEK (the abstract states 24 cases reported, 23 analysable). Pooled BCVA improved from 1.61 to 1.07 logMAR (the 2 eyes of Auffarth et al. were excluded for lack of final VA) and CCT fell from 771 to 580 µm (both p < 0.001), but rebubbling was needed in 11 of 23 eyes (47.8%) and comorbidities may have limited visual outcomes. Both own cases cleared without rebubbling at 3 months (Case 1 had a small, stable peripheral detachment). The authors report AS-OCT (both cases) and IVCM (Case 1, 2 months) changes similar to those after endothelial keratoplasty, except that IVCM showed no hyper-reflective donor-host interface. The authors conclude EndoArt shows promise in complex eyes where keratoplasty has failed or carries a high risk of failure, including failed PK.

Davide Romano 1,* , Mariacarmela Ventura 1 , Sabrina Vaccaro 1 , Eliana Forbice 1 , Scott Hau 2,3,4 , Francesco Semeraro 1 and Vito Romano 1

Review2 patients1 year or lessOverlapping cohort
2023

Pull-through insertion of EndoArt for complex eyes

Mohammed M. AbusayfAmerican Journal of Ophthalmology Case Reports
Case report of EndoArt in a complex eye (pseudophakic bullous keratopathy, aniridia, prior vitrectomy, tube implants) in which the first device was lost to the vitreous; a second device was implanted by pull-through insertion and anchored with a suture. Partial detachment of the implant, gas escape into the vitreous and inferior IOL subluxation on day 1 led to a same-day second surgery (PPV with retrieval of the first device from the vitreous, IOL refixation, 3 additional anchoring sutures and 12% C3F8). Over 1 year CCT fell from 911 to 691 µm, edema gradually improved (mild edema remaining at 12 months) and all bullae resolved. The authors suggest pull-through insertion can help improve control over the implant in very complicated eyes.

Mohammed M. Abusayf a,d , Gavin S. Tan a,b,c , Jodhbir S. Mehta a,b,c,*

Case report1 patient1 year or less
2023

Early Outcomes of an Artificial Endothelial Replacement Membrane Implantation After Failed Repeat Endothelial Keratoplasty

Luigi FontanaCornea
In 5 eyes with chronic corneal edema after 2 or more failed endothelial keratoplasties, EndoArt reduced mean CCT from 805 to 588 µm at 6 months (P = 0.015) with a clear central cornea in all eyes. Mean CDVA improved from 1.26 to 0.74 logMAR (P = 0.062, not significant), improving in 4 and worsening in 1 eye with IOP decompensation. 4 of 5 implants partially detached within 2 months and required rebubbling; all patients reported less ocular pain.

Luigi Fontana, MD, PhD,*† Natalie di Geronimo, MD,*† Michela Cennamo, MD,‡ Rita Mencucci, MD,‡ Piera Versura, BSD,*† and Antonio Moramarco, MD*†

Clinical study5 patients1 year or lessOverlapping cohort
2021

Implantation of an Artificial Endothelial Layer for Treatment of Chronic Corneal Edema

Gerd U. AuffarthCornea
In 2 compassionate-use eyes with chronic corneal edema after failed DMEK, EndoArt implantation produced rapid corneal deturgescence (CCT 730 -> 526 µm and 761 -> 457 µm at 17 months). The lamella dislocated in both eyes and was repositioned with air, after which CCT remained stable. The authors present the device as feasible and a possible alternative to DMEK, to be confirmed in larger studies.

Gerd U. Auffarth, MD, PhD,* Hyeck-Soo Son, MD,* Matthias Koch, MD,* Jan Weindler, MD,* Patrick Merz, PhD,* Ofer Daphna, MD,† Arie L. Marcovich, MD,†‡§ and Victor A. Augustin, MD*

Case report2 patientsMore than 1 YearOverlapping cohort
2021

Approaches for corneal endothelium regenerative medicine

Pere CatalàProgress in Retinal and Eye Research
Reviews current and emerging therapies for corneal endothelial regeneration, addressing global tissue shortage and innovative treatments such as EndoArt. Acellular graft substitutes such as EndoArt offer an attractive solution to tissue shortage, but future studies are needed to determine whether they are successful enough for large scale clinical use and for what indication; how long the cornea remains transparent and whether edema recurs remain uncertain.

Pere Català a,b, Gilles Thuret c,d, Heli Skottman e, Jodhbir S. Mehta f,g,h, Mohit Parekh i,j,k, Sorcha Ní Dhubhghaill l,m, Rob W.J. Collin n,o, Rudy M.M.A. Nuijts a, Stefano Ferrari j, Vanessa L. S. LaPointe b, Mor M. Dickman a,b,*

Review8 patientsOther
2021

The Eye Center of the Third Hospital of Peking University Successfully Performed the First Artificial Corneal Endothelial Transplantation in China

Hong JingChina Ophthalmology Mobile News (news article)
News report of the first EndoArt implantation in China (Peking University Third Hospital, 30-Nov-2021), in a patient with severe corneal edema (total corneal thickness 1892 µm) recurring after endothelial keratoplasty. Corneal edema subsided after surgery with attachment of the implant and was markedly reduced at 2 weeks; no postoperative CCT or visual acuity is reported. The article presents the case as showing the potential of artificial endothelial implants given the shortage of donor corneas in China.

No individual author named (byline: China Ophthalmology Mobile News); reports surgery by Professor Hong Jing's team

News1 patientOther