Future direction of corneal transplantation with new and innovative options for keratoconus and ectasia: descriptive review

Recent advancements in the treatment of keratoconus and ectasia indicate a new era in managing these conditions, with promising innovations aimed at delaying or potentially preventing the need for invasive corneal transplantation. This review evaluates contemporary treatment modalities by analyzing recent literature on innovative techniques including corneal allogenic intrastromal ring segment insertion using both surgeon-prepared and technician-prepared donor corneas; lenticular insertion techniques such as implantation of keratorefractive lenticule extraction and xenograft implants, and Bowman layer transplantation. A comprehensive review of 132 articles published between January 2017 and April 2024 was conducted. This review aims to elucidate these emerging techniques for better understanding and adoption, providing detailed descriptions and assessing clinical outcomes and complications associated with each approach. By consolidating current knowledge, this review seeks to guide clinicians in selecting appropriate interventions and optimizing patient care for those affected by keratoconus and ectasia.