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Cornea
The cornea is a clear, avascular structure covering the anterior surface of the eye that refracts light to enable vision and protects the interior of the eye from damage. As the cornea is exposed to the environment, it is susceptible to damage from both mechanical causes (scratching) and from infection. A corneal injury in an otherwise healthy patient typically heals within 1-3 days. However, in patients with underlying conditions including limbal stem cell deficiency and type II diabetes, the corneal wound healing process can be greatly prolonged1. As the cornea is highly innervated, these non-healing corneal ulcers and recurrent corneal erosions are very painful and greatly diminish the quality of life of patients experiencing them1.
Cell signaling
When an otherwise healthy cornea is injured, calcium signaling events in the cells adjacent to the wound precede and prompt cellular migration into the wound bed, where they close the injury without the risk of scarring2,3. These signaling events have been well-characterized in corneal epithelial cell culture models using live cell imaging2. Preliminary experiments demonstrate significantly more calcium signaling after injury in non-diabetic cells compared to diabetic cells. However, characterization of the cell signaling events in ex vivo globes has proved to be a technical challenge.
Live cell imaging
Previous studies have successfully recorded calcium signaling events from in vitro cell culture models of corneal wound healing4,5,6. Developing a methodology to produce high-quality images of these signaling events in ex vivo tissue is of great interest because it would permit the study of these events in a more complex and true-to-life system. Previous approaches have involved dissection of the cornea followed by immobilization in a UV-induced PEG gel7,8,9. Immobilization is an essential yet challenging step when working with live tissue, as it must remain viable and hydrated throughout the course of the experiment. Furthermore, immobilization must not damage the tissue. While the PEG solution immobilized the tissue, the resolution and quality of the images produced were not consistent. Therefore, 3D printed holders were developed to immobilize intact globes to produce higher-quality images with less risk of tissue damage.
The approach
A unique 3D printed holder was developed to immobilize intact ex vivo globes for live cell imaging. This holder prevents damage from two major sources: it allows for imaging of an enucleated globe without the need to dissect the cornea, and it eliminates exposure to UV light. Without these sources of damage, the images obtained more accurately represented the response to the scratch injuries made experimentally. Furthermore, the 3D printed holder was calibrated to the precise dimensions of the murine eye. This provided a much better fit than immobilization in PEG solution, leading to a higher-quality image at lower-powered objectives due to decreased tissue movement. A cover bar attached to the top of the holder ensures that the globe remains immobile throughout the duration of the experiment and that there is no displacement of the globe when growth media is applied to maintain hydration and viability. The ability to print the holder to precise dimensions also allows us to generate an optimal fit for murine eyes of different sizes due to the age or disease status. This technology can be applied more broadly to develop holders for the eyes of different species based on their dimensions.