Abstract
The worldwide limited availability of suitable corneal donor tissue has led to the development of alternatives, including keratoprostheses (Kpros) and tissue engineered (TE) constructs. Despite advances in bioscaffold design, there is yet to be a corneal equivalent that effectively mimics both the native tissue ultrastructure and biomechanical properties. Human decellularized corneas (DCs) could offer a safe, sustainable source of corneal tissue, increasing the donor pool and potentially reducing the risk of immune rejection after corneal graft surgery. Appropriate, human-specific, decellularization techniques and high-resolution, non-destructive analysis systems are required to ensure reproducible outputs can be achieved. If robust treatment and characterization processes can be developed, DCs could offer a supplement to the donor corneal pool, alongside superior cell culture systems for pharmacology, toxicology and drug discovery studies.
Highlights
Corneal blindness encompasses a complex profile of clinical indications, all presenting with a loss of functional vision that affects millions of people worldwide [1,2,3,4]
We have shown that these CD34+ cells have the ability to differentiate into corneal epithelial cells and it may be possible that these stem cells play a role in corneal regeneration in vivo
The limited availability of suitable corneal donor tissue has led to the development of alternative corneal equivalents including KPros and tissue engineered (TE) corneas
Summary
Corneal blindness encompasses a complex profile of clinical indications, all presenting with a loss of functional vision that affects millions of people worldwide [1,2,3,4]. The use of cadaveric donor corneal grafts (allografts) for transplantation is routine in current clinical practice. The biggest current limitation to corneal transplantation is the supply of high quality donor tissue [9]. This shortfall differs drastically between territories, with westernized nations generally well provided for [10,11], and demand in Africa and Asia considerably outstripping supply [11,12]. Xenografts are rejected more quickly than graft derived from another compared to human corneas and are allograft tissues when similar tissues and species [33].
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