Designing an innovative bioreactor destined to improve the endothelial viability of stored corneas

Purpose Loss of intraocular pressure (IOP) after death and after corneo‐scleral procurement triggers a stromal swelling causing posterior folds in which endothelial mortality is increased. We hypothesized that restoration of IOP after procurement will be key for long‐term corneal storage with preserved endothelial functions. Methods We designed two bioreactors (BR) (for human and porcine corneas) and their control units. The BR presented as a sterile disposable cassette comprising a corneal chamber with transparent windows surrounded by the fluidic system. Sterile sampling sites were added in the circuit for monitoring physiochemical parameters as well as sterility without risk of contamination. Results After insertion of the corneo‐scleral rim, the system was closed and the cassette connected to its control unit, comprising a peristaltic pump driven by a microcontroller. In a comparative study (ongoing) on paired corneas, the BR maintained a normal corneal thickness and transparency during the storage, while reducing the number of endothelial folds and increasing the endothelial viability. Conclusions The innovative BR restores IOP while ensuring a continuous medium renewal in a fully transparent chamber. The BR will be available for eye banks, research laboratories, contract research organizations, and cosmetic industry. GRANTS: AP looks for from ANSM, EFS, UJM.