Simulation of DSAEK in a new corneal bioreactor

Purpose Penetrating keratoplasty or endothelial graft remain the only available treatments for several advanced corneal diseases. However there is an important mismatch between global needs and offer. Tissue bioengineering is booming and emerging as a promising solution to the current shortage of organs. Our laboratory is working on a large project of corneal bioengineering and has developed and patented a corneal bioreactor (BR) that allows restoration of transcorneal pressure gradient and continuous fluid circulation while allowing right through observation of the cornea with the main instruments available in ophthalmology. This BR will be next available for experimental works and for eye banking. Aim: to establish the proof of concept of integration and bio‐functional evaluation of endothelial graft in the BR Methods We performed a surgical simulation of DSAEK in our new corneal BR. Conventional Descemet stripping was performed and the denuded area covered with the endothelial lamella before placing the cornea into the BR. An air bubble was let in place for 2 hours and the pressure set at 30 mmHg and the returned to 20 mmHg. Slit lamp examination, OCT with pachymetry and a study of transparency were made every 2 hours Results Initial pachymetry was 1530μm. After 24 hours, the corneal transparency improved and central corneal thickness dropped to 836μm. No liquid interface between the endothelial lamella and the cornea was visible in OCT Conclusion By reproducing physiological conditions, the BR allows simulation of a DSAEK. It represents an interesting tool for corneal bioengineering. Grant: ABM 2012, EFS 2012, ANSM 2012