Evaluation of electrospun scaffolds for potential use as lamellar corneal DMEK transplants in eye surgery

Descemet's Membrane Endothelial Keratoplasty (DMEK) is one of the most common therapies to re-establish visual acuity caused by corneal endothelial cell loss. Donor tissue shortages become increasingly relevant. Therefore, the main objective of this study was the evaluation of potential fiber substitute materials suitable for DMEK. Six electrospun biomaterials (three degradable: poly-l-lactide (PLLA), PLLA plus lecithin and tetraethylammonium chloride (PLLA+), polydioxanone (PDO); three non-degradable: polyurethanes (TSPEU, TSPCU), thermoplastic elastomer (TPC-ET) were examined regarding their structure, transparency, cell viability, metabolic cell activity, and endothelial phenotypic markers. Cell behavior was assessed on plasma-activated as well as on non-activated biomaterials to distinguish a possible influence of cold plasma activation. All biomaterials were suitable scaffolds for endothelial cells (HCEC) in varying degrees. No significant differences could be found between plasma-activated and non-activated scaffolds. PLLA+ ranked highest in total cell number. All biomaterials were comparable regarding cell toxicity, with high levels of cell viability. qPCR analysis revealed higher expression of genes responsible for HCEC's proliferation and morphology cultured on TSPEU, PLLA, and PLLA+. In summary, PLLA and PLLA+ showed the highest number of cells with high viability and cell proliferation whilst preserving their phenotype. In addition, PLLA and PLLA+ ranked highest in light transmission, which makes them promising candidates as artificial DMEK replacements.