Cataract is the leading reason of blindness worldwide and is defined by the presence of any lens opacities or loss of transparency. The most common symptoms of cataract are impaired vision, decreased contrast sensitivity, color disturbance, and glare. Oxidative stress is among the main mechanisms involved in the development of age-related cataract. Surgery through phacoemulsification and intraocular lens implantation is the most effective method for cataract treatment, however, there are chances of serious complications and irreversible loss of vision associated with the surgery. Natural compounds consisting of antioxidant or anti-inflammatory secondary metabolites can serve as potential leads for anticataract agents. In this review, we tried to document medicinal plants and plant-based natural products used for cataract treatment worldwide, which are gathered from available ethnopharmacological/ethnobotanical data. We have extensively explored a number of recognized databases like Scifinder, PubMed, Science Direct, Google Scholar, and Scopus by using keywords and phrases such as “cataract”, “blindness”, “traditional medicine”, “ethnopharmacology”, “ethnobotany”, “herbs”, “medicinal plants”, or other relevant terms, and summarized the plants/phytoconstituents that are evaluated in different models of cataract and also tabulated 44 plants that are traditionally used in cataract in various folklore medical practices. Moreover, we also categorized the plants according to scientific studies carried out in different cataract models with their mechanisms of action.
Total bilateral limbal stem cell deficiency results from various pathologies, from burns (either chemical or physical) to Sjogren Syndrome, aniridia or ocular cicatricial pemphigoid. After the loss of stem cells, normal corneal epithelium is replaced by a more opaque and vascularized conjunctival epithelium, causing loss of vision. After 1997, cultivation techniques for limbal stem cells became possible. In parallel, cultivation techniques for oral mucosa epithelial cells were also available. The aim of our review was to summarize the clinical outcomes following allogenic cultured limbal stem cell transplant (allogenic CLET), and on the other hand, oral mucosa derived epithelium transplant (cultivated oral mucosa epithelial transplant-COMET or cultivated autologous oral mucosal epithelial cell sheet-CAOMECS), in the case of total bilateral limbal stem cell loss. Thirty studies matching the inclusion criteria were found. The clinical improvement in both methods was reported similar, with percentages higher than 50% of the treated cases. However, the comparison between studies was difficult to achieve due to the lack of a universal and objective grading tool for assessing post-operative results. The definition of clinical improvement was problematic, because success was defined differently, depending on the study. Moreover, some of the studies followed both autologous and allogenic CLET, but described the results together, for both procedures, and therefore it was impossible to analyze them separately. COMET presented some advantages compared to CLET. By using autologous cells, there was no risk of immune activation and no immunosuppression was needed. COMET, however, might be associated with increased risk of persistent epithelial defects and graft failure, compared with allogenic CLET.
Although the human eye is an easily accessible sensory organ, it remains a challenge for drug administration due to the presence of several anatomical and physiological barriers which limit the access of drugs to its internal structures. Molecular imprinting technology may be considered the avant-garde approach in advanced drug delivery applications and, in particular, in ocular therapy. In fact, molecularly imprinted polymers hold the promise to compensate for the current shortcomings of the available arsenal of drug delivery systems intended for ocular therapy. The present manuscript aims to review the recent advances, the current challenges and most importantly to raise awareness on the underexplored potential and future perspectives of molecularly imprinted polymer-based drug delivery systems intended for the treatment of eye diseases.
Oxidative stress may induce a series of pathophysiological modifications that are directly involved in the development of ophthalmic diseases like age-related cataract, macular degeneration or diabetic retinopathy, considered to be responsible for the majority of vision loss cases. Although various treatment options for eye diseases are available, multiple factors could limit their efficacy. Recently, the accelerated development of ophthalmic nanosystems has provided new possibilities for overcoming the limitations of existing ocular drug delivery methods. This review evaluates the current status of ophthalmic nanosystems loaded with antioxidants for the prevention and treatment of several eye diseases.
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