# Bioengineering Strategies for Corneal Endothelial Cell Injection Therapy: Advances, Challenges, and Clinical Translation

## TL;DR

This paper reviews bioengineering approaches for injecting corneal endothelial cells to treat vision loss, offering a less invasive alternative to traditional corneal transplants.

## Contribution

The paper presents a comprehensive review of recent bioengineering strategies and clinical translation potential for corneal endothelial cell injection therapy.

## Key findings

- Cell-based therapies using corneal endothelial cells offer a minimally invasive alternative to traditional corneal transplants.
- Recent advances include sourcing cells from donor tissue, pluripotent stem cells, and transdifferentiated somatic cells.
- Optimization of culture conditions and delivery protocols is critical for successful clinical translation.

## Abstract

Corneal endothelial dysfunction is a leading cause of vision impairment globally, traditionally managed through donor-dependent keratoplasty procedures. However, limitations in donor tissue availability, surgical complexity, and long-term graft survival have prompted the development of cell-based regenerative therapies. Among these, corneal endothelial cells (CECs) injection therapy has emerged as a minimally invasive alternative, offering the potential to restore endothelial function. This review provides a comprehensive analysis of recent advances in bioengineering strategies for CECs therapy, including cell sourcing from donor tissue, pluripotent stem cells, and transdifferentiated somatic cells; optimization of culture conditions and substrates; and delivery protocols that enhance cell adhesion and survival. We further examine clinical trial outcomes and propose future directions for clinical translation. The convergence of cell biology, biomaterials engineering, and translational medicine positions CECs injection therapy as a transformative solution to corneal blindness.