Prospects for Descemet Stripping Automated Endothelial Keratoplasty Using Cultured Human Corneal Endothelial Cells

Study background: Descemet stripping automated endothelial keratoplasty (DSAEK) allows selective replacement of the diseased corneal endothelium. However, DSAEK requires a donor cornea and the worldwide shortage of corneas limits its application. In this review, we introduce our recent work on tissue engineering for DSAEK using cultured human corneal endothelial cells (HCEC) and recently published experimental data on HCEC precursors. Methods and Results: We seeded DiI-labeled cultured HCECs onto collagen sheets, yielding HCEC sheets. The pump function parameters of these sheets were 76% to 95% of those for human donor corneas. Then HCEC sheets were transplanted onto the posterior stroma of New Zealand white rabbits after Descemetorhexis (DSAEK group). Rabbit corneas with only Descemetorhexis were the control group. The mean corneal thickness was significantly smaller in the DSAEK group than in the untransplanted control group throughout the observation period. DiI-labeled cells covered the posterior corneal surface in the DSAEK group. Severe stromal edema was detected in the control group by microscopy with hematoxylin-eosin staining, but not in the DSAEK group. Next, we isolated HCEC precursors from human donor corneas. Cultured precursor cells formed sphere colonies that expressed neural and mesenchymal proteins. The progeny of these colonies were HCEC-like hexagonal cells. Cell sheets constructed using HCEC precursors showed stronger staining for BrdU and nestin than cell sheets constructed with differentiated cultured HCECs. Conclusions: These findings indicate that cultured HCECs transplanted from adult human donor corneas retain their corneal dehydration function and suggest the feasibility of performing DSAEK with HCECs to treat endothelial dysfunction. Adult human corneal endothelium contains precursors that can differentiate into corneal endothelial cells. HCEC precursors may become a powerful tool for the construction of HCEC-coated collagen sheets. *Corresponding author: Tatsuya Mimura, Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan, Tel: +81 35800-5108 (Ex33503); Fax: +81 33817-0798; E-mail: [email protected] Received September 24, 2011; Accepted November 11, 2011; Published November 15, 2011 Citation: Mimura T, Yamagami S, Yokoo S, Usui T, Amano S (2011) Prospects for Descemet Stripping Automated Endothelial Keratoplasty Using Cultured Human Corneal Endothelial Cells. J Transplant Technol Res S2:001. doi:10.4172/21610991.S2-001 Copyright: © 2011 Mimura T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.