Revisiting corneal storage using an innovative bioreactor

Be it at 4°C or in organ‐culture at 31°C, two techniques no revisited since 70’, corneal storage is mandatorily accompanied by a significant endothelial cell (EC) death (600x more than during lifetime and stromal swelling responsible for endothelial folds triggering EC apoptosis. The absence of intra ocular pressure that constitutes one of the main forces opposed to the naturally hydrophilic stroma may play an important role in this vicious circle that begins with donor death and is prolonged during storage. The restoration of pressure gradient with circulation of fluids during long term storage may improve EC survival and reduce stromal swelling. Review of the literature and of patents on methods available to achieve ex vivo restoration of the corneal physiology and personal works of our laboratory of bioengineering with a patented corneal bioreactor. Several devices have been published or patented previously but none with the aim of improving storage (generally for short‐term toxicologic studies) and none using the technical solutions that we developed. Restoration of an increased pressure at the endothelial side associated with a continuous renewal of storage medium allowed rapidly reduction of stromal swelling and improvement of EC viability, compared to the rustic immersion in a sealed flask. Our innovative bioreactor could be used for research studies as well as for corneal storage in a next future in eye banks. Grant: Agence de la BioMédecine appel à projet recherche et greffe 2012