New developments in corneal endothelial cell replacement
Acta Ophthalmologica, vol. 99, pp. 712–729
Abstract
Corneal transplantation is currently the most effective treatment to restore corneal clarity in patients with endothelial disorders. Endothelial transplantation, either by Descemet membrane endothelial keratoplasty (DMEK) or by Descemet stripping (automated) endothelial keratoplasty (DS(A)EK), is a surgical approach that replaces diseased Descemet membrane and endothelium with tissue from a healthy donor eye. Its application, however, is limited by the availability of healthy donor tissue. To increase the pool of endothelial grafts, research has focused on developing new treatment options as alternatives to conventional corneal transplantation. These treatment options can be considered as either 'surgery-based', that is tissue-efficient modifications of the current techniques (e.g. Descemet stripping only (DSO)/Descemetorhexis without endothelial keratoplasty (DWEK) and Quarter-DMEK), or 'cell-based' approaches, which rely on in vitro expansion of human corneal endothelial cells (hCEC) (i.e. cultured corneal endothelial cell sheet transplantation and cell injection). In this review, we will focus on the most recent developments in the field of the 'cell-based' approaches. Starting with the description of aspects involved in the isolation of hCEC from donor tissue, we then describe the different natural and bioengineered carriers currently used in endothelial cell sheet transplantation, and finally, we discuss the current 'state of the art' in novel therapeutic approaches such as endothelial cell injection.
Authors 8
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Netherlands Institute for Innovative Ocular Surgery
Affiliation as printed
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Netherlands Institute for Innovative Ocular Surgery
Affiliation as printed
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Netherlands Institute for Innovative Ocular Surgery
Affiliation as printed
Melles Cornea Clinic Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Melles Cornea Clinic, Rotterdam, The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Netherlands Institute for Innovative Ocular Surgery · Singapore Eye Research Institute
Affiliation as printed
Melles Cornea Clinic Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Tissue Engineering and Stem Cell Group Singapore Eye Research Institute Singapore Singapore
Melles Cornea Clinic, Rotterdam, The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
Tissue Engineering and Stem Cell Group, Singapore Eye Research Institute, Singapore, Singapore
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Martine Johanna Jager Aachen Department of Ophthalmology Leiden University Medical Center Leiden the Netherlands Department of Ophthalmology, Leiden University Medical Center
Leiden University Medical Center
Affiliation as printed
Department of Ophthalmology Leiden University Medical Center Leiden The Netherlands
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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Netherlands Institute for Innovative Ocular Surgery · Rotterdam Eye Hospital
Affiliation as printed
Amnitrans EyeBank Rotterdam The Netherlands
Melles Cornea Clinic Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Amnitrans EyeBank, Rotterdam, The Netherlands
Melles Cornea Clinic, Rotterdam, The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Netherlands Institute for Innovative Ocular Surgery · Antwerp University Hospital
Affiliation as printed
Antwerp University Hospital (UZA) Edegem Belgium
Melles Cornea Clinic Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Antwerp University Hospital (UZA), Edegem, Belgium
Melles Cornea Clinic, Rotterdam, The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Silke Oellerich corresponding
Netherlands Institute for Innovative Ocular Surgery
Affiliation as printed
Netherlands Institute for Innovative Ocular Surgery Rotterdam The Netherlands
Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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