Transplantation of human corneal limbal epithelial cell sheet harvested on synthesized carboxymethyl cellulose and dopamine in a limbal stem cell deficiency

Biomaterials for Corneal Regeneration

Corneal blindness is a significant reason for visual impairment globally. Researchers have been investigating several methods for corneal regeneration in order to cure these patients. Biomaterials are favored due to their biocompatibility and capacity to promote cell adhesion. A variety of natural and synthetic biomaterials, along with decellularized cornea, have been employed in corneal wound healing. Commonly utilized natural biomaterials encompass proteins such as collagen, gelatin, and silk fibroin (SF), as well as polysaccharides including alginate, chitosan (CS), hyaluronic acid (HA), and cellulose. Synthetic biomaterials primarily consist of polyvinyl alcohol (PVA), poly(ε-caprolactone) (PCL), and poly (lactic-co-glycolic acid) (PLGA). Bio-based materials and their composites are primarily utilized as hydrogels, films, scaffolds, patches, nanocapsules, and other formats for the treatment of blinding ocular conditions, including corneal wounds, corneal ulcers, corneal endothelium, and stromal defects. This review attempts to summarize in vitro, preclinical, and clinical trial studies relevant to corneal regeneration using biomaterials within the last five years, and expect that these experiences and outcomes will inspire and provide practical strategies for the future development of biomaterials for corneal regeneration. Furthermore, potential improvements and difficulties for these biomaterials are discussed.

A review of cellulose-based catechol-containing functional materials for advanced applications

With the increment in global energy consumption and severe environmental pollution, it is urgently needed to explore green and sustainable materials. Inspired by nature, catechol groups in mussel adhesion proteins have been successively understood and utilized as novel biomimetic materials. In parallel, cellulose presents a wide class of functional materials rating from macro-scale to nano-scale components. The cross-over among both research fields alters the introduction of impressive materials with potential engineering properties, where catechol-containing materials supply a general stage for the functionalization of cellulose or cellulose derivatives. In this review, the role of catechol groups in the modification of cellulose and cellulose derivatives is discussed. A broad variety of advanced applications of cellulose-based catechol-containing materials, including adhesives, hydrogels, aerogels, membranes, textiles, pulp and papermaking, composites, are presented. Furthermore, some critical remaining challenges and opportunities are studied to mount the way toward the rational purpose and applications of cellulose-based catechol-containing materials.

Replace or Regenerate? Diverse Approaches to Biomaterials for Treating Corneal Lesions

The inner structures of the eye are protected by the cornea, which is a transparent membrane exposed to the external environment and subjected to the risk of lesions and diseases, sometimes resulting in impaired vision and blindness. Several eye pathologies can be treated with a keratoplasty, a surgical procedure aimed at replacing the cornea with tissues from human donors. Even though the success rate is high (up to 90% for the first graft in low-risk patients at 5-year follow-up), this approach is limited by the insufficient number of donors and several clinically relevant drawbacks. Alternatively, keratoprosthesis can be applied in an attempt to restore minimal functions of the cornea: For this reason, it is used only for high-risk patients. Recently, many biomaterials of both natural and synthetic origin have been developed as corneal substitutes to restore and replace diseased or injured corneas in low-risk patients. After illustrating the traditional clinical approaches, the present paper aims to review the most innovative solutions that have been recently proposed to regenerate the cornea, avoiding the use of donor tissues. Finally, innovative approaches to biological tissue 3D printing and xenotransplantation will be mentioned.

Animal Models for Limbal Stem Cell Deficiency: A Critical Narrative Literature Review

This literature review will provide a critical narrative overview of the highlights and potential pitfalls of the reported animal models for limbal stem cell deficiency (LSCD) and will identify the neglected aspects of this research area. There exists significant heterogeneity in the literature regarding the methodology used to create the model and the predefined duration after the insult when the model is supposedly fully fit for evaluations and/or for testing various therapeutic interventions. The literature is also replete with examples wherein the implementation of a specific model varies significantly across different studies. For example, the concentration of the chemical, as well as its duration and technique of exposure in a chemically induced LSCD model, has a great impact not only on the validity of the model but also on the severity of the complications. Furthermore, while some models induce a full-blown clinical picture of total LSCD, some are hindered by their ability to yield only partial LSCD. Another aspect to consider is the nature of the damage induced by a specific method. As thermal methods cause more stromal scarring, they may be better suited for assessing the anti-fibrotic properties of a particular treatment. On the other hand, since chemical burns cause more neovascularisation, they provide the opportunity to tap into the potential treatments for anti-neovascularisation. The animal species (i.e., rats, mice, rabbits, etc.) is also a crucial factor in the validity of the model and its potential for clinical translation, with each animal having its unique set of advantages and disadvantages. This review will also elaborate on other overlooked aspects, such as the anaesthetic(s) used during experiments, the gender of the animals, care after LSCD induction, and model validation. The review will conclude by providing future perspectives and suggestions for further developments in this rather important area of research.

Biocompatibility and Transplantation Efficacy of the C-Clear Artificial Cornea in a Rabbit Chemical Burn Model

We investigated the bioavailability and stability of a C-Clear artificial cornea in a rabbit chemical burn model. Thirty-six rabbits were divided into a control group (n = 16) and a chemical burn group that used NaOH solution (n = 20). After lamellar dissection, the central posterior lamella was excised using a 3 mm diameter trephine, and an artificial cornea was transplanted into the lamellar pocket. After 2 weeks, the central anterior lamella was excised using a 3 mm diameter trephine to secure a clean visual axis. We examined the anterior segment of the eyes weekly for 12 weeks after transplantation. Successful subjects whose artificial corneas were maintained stably for 12 weeks were euthanized and underwent histologic examinations. Artificial corneas remained stable for up to 12 weeks in 62.5 and 50% of rabbits in the control and chemical burn groups, respectively. Two rabbits in the chemical burn group showed the formation of a retroprosthetic membrane, and one rabbit with visual axis blockage underwent membrane removal using a Nd:YAG laser. In histologic examinations, adhesion between artificial cornea and peripheral corneal stoma was observed. In conclusion, we confirmed structural stability and biocompatibility of the C-Clear artificial cornea for up to 12 weeks after implantation in control and chemical burn groups.

Profile of biological characterizations and clinical application of corneal stem/progenitor cells

Corneal stem/progenitor cells are typical adult stem/progenitor cells. The human cornea covers the front of the eyeball, which protects the eye from the outside environment while allowing vision. The location and function demand the cornea to maintain its transparency and to continuously renew its epithelial surface by replacing injured or aged cells through a rapid turnover process in which corneal stem/progenitor cells play an important role. Corneal stem/progenitor cells include mainly corneal epithelial stem cells, corneal endothelial cell progenitors and corneal stromal stem cells. Since the discovery of corneal epithelial stem cells (also known as limbal stem cells) in 1971, an increasing number of markers for corneal stem/progenitor cells have been proposed, but there is no consensus regarding the definitive markers for them. Therefore, the identification, isolation and cultivation of these cells remain challenging without a unified approach. In this review, we systematically introduce the profile of biological characterizations, such as anatomy, characteristics, isolation, cultivation and molecular markers, and clinical applications of the three categories of corneal stem/progenitor cells.

Polysaccharides, as biological macromolecule-based scaffolding biomaterials in cornea tissue engineering: A review

Corneal-related diseases and injuries are the leading causes of vision loss, estimated to affect over 10 million people worldwide. Currently, cadaveric corneal grafts are considered the gold standard of treatment to restore cornea-related vision. However, this treatment modality faces different challenges such as donor shortage and graft failure. Therefore, the need for alternative solutions continues to grow. Tissue engineering has dramatically progressed to produce artificial cornea implants in order to repair, regenerate, or replace the damaged cornea. In this regard, a variety of polysaccharides such as cellulose, chitosan, alginate, agarose, and hyaluronic acid have been widely explored as scaffolding biomaterials for the production of tissue-engineered cornea. These polymers are known for their excellent biocompatibility, versatile properties, and processability. Recent progress and future perspectives of polysaccharide-based biomaterials in cornea tissue engineering is reviewed here.