EndoArt Synthetic, Artificial Endothelial Layer Implant

EndoArt is a synthetic, artificial endothelial layer implant used primarily to treat chronic corneal edema and endothelial failure. While keratoconus primarily involves thinning and bulging of the cornea, EndoArt can be relevant in advanced or complex cases—specifically when a patient has developed corneal swelling (edema) after previous failed transplants or when traditional surgery is too high-risk. [1, 2, 3, 4, 5]

 

How EndoArt Works

The device acts as a passive, impermeable barrier that blocks excess fluid from entering the cornea from the eye's anterior chamber. By reducing fluid buildup, it restores corneal clarity and helps alleviate the pain associated with chronic swelling. [1, 2, 3, 4]

• Synthetic Nature: Because it is made of a biocompatible acrylic polymer, there is no risk of immune rejection, unlike traditional human donor tissue.
• Off-the-Shelf Availability: It does not require a human donor, meaning it is instantly available and has a long shelf life.
• Minimally Invasive: The procedure typically takes 30–40 minutes and involves inserting the implant through a small incision, where it is held in place by a gas bubble. [1, 2, 3, 4] 

 

Use in Keratoconus

While not a standard first-line treatment for keratoconus, EndoArt is used as a salvage therapy for complex scenarios including: [1, 2]

• Failed Transplants: For keratoconus patients who have undergone multiple failed corneal grafts (like PKP, DALK, or DMEK).
• High-Risk Cases: Patients with other comorbidities like glaucoma or those who are unsuitable for further human tissue transplants.
• Symptom Relief: It is effective at treating pain and photophobia in eyes where full visual restoration might not be possible but comfort is the priority. [1, 2, 3, 4, 5] 

Clinical Results

Studies show that EndoArt significantly reduces central corneal thickness (CCT) and improves visual acuity in most patients. However, a common postoperative management step is "re-bubbling," where additional gas is injected into the eye to ensure the implant stays fully attached. [1, 2, 3, 4]