Concise Review: An Update on the Culture of Human Corneal Endothelial Cells for Transplantation

Abstract

The cornea forms the front window of the eye, enabling the transmission of light to the retina through a crystalline lens. Many disorders of the cornea lead to partial or total blindness, and therefore corneal transplantation becomes mandatory. Recently, selective corneal layer (as opposed to full thickness) transplantation has become popular because this leads to earlier rehabilitation and visual outcomes. Corneal endothelial disorders are a common cause of corneal disease and transplantation. Corneal endothelial transplantation is successful but limited worldwide because of lower donor corneal supply. Alternatives to corneal tissue for endothelial transplantation therefore require immediate attention. The field of human corneal endothelial culture for transplantation is rapidly emerging as a possible viable option. This manuscript provides an update regarding these developments. Significance: The cornea is the front clear window of the eye. It needs to be kept transparent for normal vision. It is formed of various layers of which the posterior layer (the endothelium) is responsible for the transparency of the cornea because it allows the transport of ions and solutes to and from the other layers of the cornea. Corneal blindness that results from the corneal endothelial dysfunction can be treated using healthy donor tissues. There is a huge demand for human donor corneas but limited supply, and therefore there is a need to identify alternatives that would reduce this demand. Research is underway to understand the isolation techniques for corneal endothelial cells, culturing these cells in the laboratory, and finding possible options to transplant these cells in the patients. This review article is an update on the recent developments in this field.

Keywords: Cell culture; Cornea; Corneal endothelial cells; Transplantation.

Figure 1.

Human eye, cornea, and endothelium. (A): Anatomy of human eye globe showing different parts of the eye. (B): Schematic representation and structure of human cornea showing specific layers of the tissue. (C): A normal human corneal endothelium seen under an inverted microscope at ×100 magnification. (D): Human corneal endothelium with high mortality rate observed using trypan blue staining at ×100 magnification. (E): Human corneal endothelium observed using alizarin red staining to check the hexagonality of the cells at ×200 magnification. (F): Human corneal endothelium expressing zonula occludens 1 marker observed under oil immersion magnification.