Potential of an Amphiphilic Artificial Corneal Endothelial Layer as a Replacement Option for Damaged Corneal Endothelium

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Abstract
Bullous keratopathy, a condition severely impacting vision and potentially leading to corneal blindness, necessitates corneal transplantation. However, the shortage of donor corneas and complex surgical procedures drive the exploration of tissue‐engineered corneal endothelial layers. This study develops a transparent, amphiphilic, and cell‐free membrane for corneal endothelial replacement. The membrane, securely attached to the posterior surface of the cornea, is created by mixing hydroxyethyl methacrylate (HEMA) and ethylene glycol dimethylacrylate (EGDMA) in a 10:1 ratio. A 50 µL volume is used to obtain a 60 µm hydrophobic membrane on both sides, with one side treated with a polyvinylpyrrolidone (PVP) solution. The resulting membrane is transparent, foldable, biocompatible, amphiphilic, and easily handled. When exposed to 20% sulfur hexafluoride (SF6), the hydrophilic side of the membrane adheres tightly to the corneal Descemet's membrane, preventing water absorption into the corneal stroma, and thus treating bullous keratopathy. Histological test confirms its effectiveness, showing normal corneal structure and low inflammation when implanted in rabbits for up to 100 d. This study showcases the potential of this membrane as a viable option for corneal endothelial replacement, offering a novel approach to address donor tissue scarcity in corneal transplantation.

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