# Stem Cell-Derived Corneal Epithelium: Engineering Barrier Function for Ocular Surface Repair

## TL;DR

This review explores using stem cells to create corneal epithelium for eye repair and testing, offering an alternative to traditional corneal transplants.

## Contribution

The paper highlights recent advances in engineering functional corneal epithelium from stem cells for clinical and testing applications.

## Key findings

- Corneal transplants face donor shortages and rejection risks, prompting the need for alternatives.
- Stem cell-derived epithelium shows promise for treating isolated corneal surface issues.
- Engineered epithelium can also be used for in vitro pharmacotoxicity testing.

## Abstract

The cornea, the transparent anterior window of the eye, critically refracts light and protects intraocular structures. Corneal pathologies, including trauma, infection, chemical injury, metabolic diseases, genetic conditions, and age-related degeneration, can lead to significant visual impairment. While penetrating keratoplasty or full-thickness corneal transplantation remains a standard and effective intervention for severe corneal dysfunction, limitations in donor tissue availability and the risk of immunogenic graft rejection necessitate alternative therapeutic strategies. Furthermore, for cases of isolated epithelial disfunction, a full-thickness cornea graft may not be required or effective. This review examines the potential of corneal epithelial constructs derived from autologous stem cells with functional barrier properties for corneal reconstruction and in vitro pharmacotoxicity testing. In this review, we delineate the current limitations of corneal transplantation, the advantages of stem cell-based approaches, and recent advances in generating engineered corneal epithelium. Finally, we address remaining technical challenges and propose future research directions aimed at clinical translation.