Abstract

Endothelial keratoplasty is a recent shift in the surgical treatment of corneal endothelial dystrophies, where the dysfunctional endothelium is replaced whilst retaining the unaffected corneal layers. To overcome the limitation of donor corneal shortage, alternative use of tissue engineered constructs is being researched. Tissue constructs with intact extracellular matrix are generated using stimuli responsive polymers. In this study we evaluated the feasibility of using the thermoresponsive poly(N-isopropylacrylamide-co-glycidylmethacrylate) polymer as a culture surface to harvest viable corneal endothelial cell sheets. Incubation below the lower critical solution temperature of the polymer allowed the detachment of the intact endothelial cell sheet. Phase contrast and scanning electron microscopy revealed the intact architecture, cobble stone morphology, and cell-to-cell contact in the retrieved cell sheet. Strong extracellular matrix deposition was also observed. The RT-PCR analysis confirmed functionally active endothelial cells in the cell sheet as evidenced by the positive expression of aquaporin 1, collagen IV, Na+-K+ ATPase, and FLK-1. Na+-K+ ATPase protein expression was also visualized by immunofluorescence staining. These results suggest that the in-house developed thermoresponsive culture dish is a suitable substrate for the generation of intact corneal endothelial cell sheet towards transplantation for endothelial keratoplasty.

Highlights

  • The cornea is the anterior transparent part of the eye and comprises five layers: the outer epithelium followed by the Bowman’s membrane, stroma, Descemet’s membrane, and the endothelium

  • Endothelial keratoplasty is a recent shift in surgical treatment wherein only the dysfunctional endothelium is replaced whilst retaining the unaffected layers [1]

  • This study further extends the possibility of NGMA in corneal tissue engineering by evaluating its potential in culturing corneal endothelial cells (CEC) and retrieval of functional corneal endothelial cell sheets

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Summary

Introduction

The cornea is the anterior transparent part of the eye and comprises five layers: the outer epithelium followed by the Bowman’s membrane, stroma, Descemet’s membrane, and the endothelium. Endothelial keratoplasty is a recent shift in surgical treatment wherein only the dysfunctional endothelium is replaced whilst retaining the unaffected layers [1]. This procedure has been reported to reduce the risks associated with penetrating keratoplasty mainly astigmatism and hemorrhage, while improving postoperative visual functions [2]. This requires the availability of donor corneas, the shortage of which still remains a limitation. The use of carriers might facilitate contamination by pathogens and affect transparency of the cornea [4, 5]

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