Silk fibroin in ocular tissue reconstruction.

The silk structural protein fibroin displays potential for use in tissue engineering. We present here our opinion of its value as a biomaterial for reconstructing tissues of clinical significance within the human eye. We review the strengths and weaknesses of using fibroin in those parts of the eye that we believe are most amenable to cellular reconstruction, namely the corneoscleral limbus, corneal stroma, corneal endothelium and outer blood-retinal barrier (Ruysch's complex). In these areas we find that by employing the range of manufacturing products afforded by fibroin, relevant structural assemblies can be made for cells expanded ex vivo. Significant questions now need to be answered concerning the effect of this biomaterial on the phenotype of key cell types and the biocompatibility of fibroin within the eye. We conclude that fibroin's strength, structural versatility and potential for modification, combined with the relative simplicity of associated manufacturing processes, make fibroin a worthy candidate for further exploration.