title: [Transplantation of corneal endothelium--chances and challenges].
abstract: BACKGROUND
  Endothelial keratoplasty is a promising surgical procedure which may replace penetrating keratoplasty in cases of endothelial cell diseases of the cornea. This method may thereby help to prevent postoperative astigmatism and transplant rejection.
  
  
  RESULTS
  A survey of publications reporting about results after endothelial keratoplasty shows that the main problem of this transplantation technique is a postoperative endothelial cell loss which is comparable to or even higher than that observed in penetrating keratoplasty. Improving surgical techniques led to a reduction of the endothelial cell loss, however, cell-based strategies to prevent postoperative cell loss or to enhance the cell densities of donor corneas or endothelial lamellae are rare.
  
  
  CONCLUSIONS
  This review presents an overview of clinical results after endothelial keratoplasty. Current strategies in the field of cell biology and tissue cultivation of corneal endothelial cells, genetic manipulation of the corneal endothelium and tissue engineering strategies aiming at the production of transplantable endothelial cell sheets are described.
  
  
  CONCLUSIONS
  The limited availability of donor corneas makes it mandatory to develop methods in the field of tissue engineering in order to improve corneal endothelial cell survival or to increase corneal endothelial cell density, using interdisciplinary approaches.
authors: Augenklinik, Klinikum Chemnitz gGmbH, Flemmingstrasse 2, Chemnitz. k.engelmann@skc.de
authors: K
authors: K
authors: Engelmann
authors: M
authors: M
authors: Valtink
authors: D
authors: D
authors: Lindemann
authors: M
authors: M
authors: Nitschke
mesh_terms: D001251:Astigmatism / Q000517:prevention & control; D049109:Cell Proliferation; D004728:Endothelium, Corneal / Q000166:cytology / Q000637:transplantation*; D005818:Genetic Engineering / Q000379:methods; D005822:Genetic Vectors / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D046509:Tissue Culture Techniques; D023822:Tissue Engineering