[Research progress and applications of biologically derived materials in scleral reconstruction].

摘要

OBJECTIVE: To review the research progress and clinical applications of biologically derived materials in scleral reconstruction. METHODS: A comprehensive review of recent domestic and international literature was conducted to systematically summarize various biologically derived materials, analyzing their therapeutic outcomes and modification strategies in posterior scleral reinforcement (PSR), scleral defect repair, and glaucoma drainage device (GDD) tube coverage. RESULTS: Biologically derived materials show distinct advantages in different scenarios of scleral reconstruction. In PSR, allogeneic sclera, dura mater, and bovine pericardium can enhance mechanical support of the posterior pole and slow axial elongation; emerging materials such as silk fibroin and gelatin methacrylcyl demonstrate potential in promoting collagen deposition and scleral remodeling. In scleral defect repair, sclera, cornea, amniotic membrane, and collagen matrix can facilitate defect closure, vascularization, and stromal integration. In GDD tube coverage, sclera, cornea, pericardium, and amniotic membrane-umbilical cord tissue can reduce the risk of tube exposure. Overall, individual materials remain limited by mechanical properties, donor availability, or biological activity. Crosslinking modification and composite reinforcement can significantly improve mechanical support and tissue-inductive capacity, promoting the transition from passive repair to active physiological remodeling. CONCLUSION: Biologically derived materials hold significant value in scleral reconstruction. The development of intelligent and multifunctional composite materials represents the core direction for future research. 目的: 总结生物源性材料在巩膜重建中的研究进展与临床应用。. 方法: 查阅近年国内外文献，对各类生物源性材料进行系统归纳，分析其在后巩膜加固术（posterior scleral reinforcement，PSR）、巩膜缺损修复和青光眼引流装置（glaucoma drainage device，GDD）覆盖中的应用效果及改性策略。. 结果: 生物源性材料在巩膜重建不同场景中各具优势。PSR中，同种异体巩膜、硬脑膜及牛心包膜可增强后极部力学支撑，延缓眼轴延长；丝素蛋白、甲基丙烯酰化明胶等新型材料显示促胶原沉积和巩膜重塑潜力。巩膜缺损修复中，巩膜、角膜、羊膜及胶原基质等可促进缺损封闭、血管化和基质整合。GDD引流管覆盖中，巩膜、角膜、心包膜及羊膜-脐带组织可降低管暴露风险。总体而言，单一材料在力学、供体或生物活性上均存局限。交联改性与复合增强技术可显著提升材料力学支撑与组织诱导能力，推动被动修复向主动生理重塑跨越。. 结论: 生物源性材料在巩膜重建中具有重要价值，智能化与复合多功能材料是未来研发核心方向。.