From ear to eye: Transparent alkali-treated autologous cartilage for corneal stromal regeneration

Corneal blindness represents a major global health burden, with donor shortage and immune rejection remaining significant challenges in transplantation therapy. Here, we present an innovative approach using autologous auricular cartilage as a sustainable tissue source for corneal regeneration. The resulting 12-h treated grafts achieved 60-70% in vitro transmittance, tensile strength of ∼2 MPa, suture retention of 0.48 N, water content of ∼78%, contact angle of ∼35°, and refractive index of 1.332 - values closely resembling native corneal stroma. In a rabbit lamellar keratoplasty model, these autologous scaffolds promoted rapid re-epithelialization, suppressed myofibroblast activation (α-SMA area reduced by ∼70% versus control, *p* < 0.01), and restored full corneal transparency and stromal architecture within 8 weeks, with significantly lower neovascularization and inflammation than controls. The autologous nature of the grafts prevented immune rejection and supported seamless tissue integration. This work establishes autologous cartilage as a clinically viable biomaterial for corneal reconstruction, offering a practical solution to donor scarcity while eliminating the need for immunosuppression. Our findings demonstrate the great potential of autologous tissue transformation in regenerative ophthalmology.