Research progress of corneal endothelial cell regeneration and replacement

Abstract

Corneal endothelial cells (CECs) are crucial for the maintenance of corneal transparency and normal visual function. Corneal endothelial dysfunction can lead to corneal edema, opacity, and even blindness. Due to the limited proliferative capacity of human CECs and the global shortage of donor cornea, corneal endothelial regeneration and replacement always represent the most challenge in the basic research and clinical treatment of corneal diseases. Although there is a potential existence of corneal endothelial progenitor cells, the efficiency of Descemet stripping without endothelial keratoplasty remains controversial. In recent years, significant advancements have been made in the field of cultured endothelial cell regeneration and artificial material replacement. Here, we reviewed the current research and clinical progress of corneal endothelial cell regeneration and replacement, including the in vitro cultivation of primary human CECs, in vitro differentiation of stem cell-derived CECs, tissue-engineered corneal endothelium, and fabrication of artificial corneal endothelium. We also discussed the remaining questions regarding innovating clinical preventive and therapeutic strategies for corneal endothelial dysfunction.