Mini-Sheet Injection for Cultured Corneal Endothelial Transplantation

Corneal endothelium is a single layer of hexagonal cells that maintains the corneal transparency and thickness through its barrier and pump function. For the treatment of corneal endothelial dysfunction, the transplantation of tissue-engineered corneal endothelium and direct injection of cultured corneal endothelial cells were developed because of the severe shortage of donor cornea worldwide. However, the technique difficulty or safety risk still remained. In this study, we report a novel mini-sheet injection for the cultured corneal endothelial cell transplantation and compare with the effects of single-cell injection in rabbit model. Compared with the reported single-cell injection, mini sheets promoted the adhesion and tight junction formation after injection. Rabbit corneal clarity and thickness were rapidly recovered after 7 days of mini-sheet injection, compared with 14 days of single-cell injection. Moreover, typical endothelial morphology was observed as early as 7 days after the mini-sheet injection, whereas until 21 days after the single-cell injection. These results demonstrate that the novel mini-sheet injection of corneal endothelial cells exhibited rapid adhesion, tight junction formation, and corneal clarity recovery, which may represent a more efficient method for the transplantation of cultured corneal endothelial cells.