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Case Reports
, 7 (1), 18-24

Human Corneal Endothelial Cell Transplantation Using Nanocomposite Gel Sheet in Bullous Keratopathy

Case Reports

Human Corneal Endothelial Cell Transplantation Using Nanocomposite Gel Sheet in Bullous Keratopathy

Periasamy Parikumar et al. Am J Stem Cells.


Transplantation of in vitro expanded human corneal endothelial precursors (HCEP) cells using a nanocomposite (D25-NC) gel sheet as supporting material in bovine's cornea has been earlier reported. Herein we report the transplantation of HCEP cells derived from a cadaver donor cornea to three patients using the NC gel sheet. In three patients with bullous keratopathy, one after cataract surgery, one after trauma and another in the corneal graft, earlier performed for congenital corneal dystrophy, not amenable to medical management HCEP cells isolated from a human cadaver donor cornea in vitro expanded using a thermoreversible gelation polymer (TGP) for 26 days were divided into three equal portions and 1.6 × 105 HCEP cells were injected on to the endothelium of the affected eye in each patient using the D25-NC gel sheet as a supporting material. The sheets were removed after three days. The bullae in the cornea disappeared by the 3rd-11th post-operative day in all the three patients. Visual acuity improved from Perception of light (PL)+/Projection of rays (PR)+ to Hand movements (HM)+ in one of the patients by post-operative day 3 which was maintained at 18 months follow-up. At 18 months follow-up, in another patient the visual acuity had improved from HM+ to 6/60 while in the third patient, visual acuity remained HM+ as it was prior to HCEP transplantation. There were no adverse effects during the follow-up in any of the patients.

Keywords: Corneal dystrophy; cell transplantation; hydrogel; nanocomposites.

Conflict of interest statement

Authors Abraham and Haraguchi are applicants to a patent on usage of NC gel sheet. Author Parikumar is a stake holder in the Light eye hospital, Dharmapuri, India.


Figure 1
Figure 1
Schematic illustration of the various steps of clinical procedure performed in the study.
Figure 2
Figure 2
Pre and Post HCEP cell transplantation pictures of the three patients (Pt); (B) (Pt I), (E) (Pt II), (H) (Pt III) show the pre-transplantation slit lamp images of the eyes in which white arrow(s) point the bullae. (C) (Pt I), (F) (Pt II), (I) (Pt III) show the respective patients’ post HCEP transplantation images with the corresponding regions where the bullae have disappeared as shown encircled. Corresponding diagrams (A, D, G) to the left show the shape of the bullae for easy identification.

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