RESTORATION OF CORNEA ENDOTHELIUM FUNCTION (REVIEW)

Review highlights modern findings on molecular mechanisms of dysfunction of human corneal endothelial cells causes decline of vision. When water enters the corneal stroma, it disorganizes the regular arrangement of the collagen fibrils, which reduces corneal transparency. Corneal endothelial cells are responsible for keeping the dehydration state of the stroma by pumping out fluid. However, this layer of cells can become deficient, for example following intra-corneal surgery or because of a pathology. Corneal transplantation is currently the only treatment in order to restore vision following endothelial dysfunctions. The authors survey methodological problems and prospects for correction of endothelial cells dysfunction. Human endothelial cells do not proliferate in vivo because these cells arrest in the G1 phase of the cell cycle. Modern research showed that corneal endothelium cells could proliferate in special conditions. An alternative approach is to use human stem cells as an endothelial cells source. New methods and improved technique of storage and preservation of corneal grafts, palliative methods of surgical treatment aimed at reducing the hydration of the surface layers of the cornea are considered. The review includes consideration of works for endothelial tissue engineering using cell culture technologies. Endothelial keratoplasty limited by the technical difficulty of the procedure, a shortage of available grafts, and the potential for graft failure or rejection. These limitations are driving researchers to develop new approaches, such as methods of organ cultur