Decellularized Corneal Extracellular Matrix-Based Injectable Hydrogel for Strengthening the Corneal Matrix in Corneal Keratoconus

Keratoconus (KC) is a non-inflammatory corneal disorder characterized by progressive thinning and protrusion of the cornea, resulting in its conical shape and loss of optical clarity. The underlying causes and mechanisms remain under investigation, though KC is widely regarded as the final manifestation of multiple abnormal biological processes leading to corneal biomechanical instability and ectasia. Current treatment options primarily involve complex or high-risk surgical procedures, including Bowman’s membrane and corneal transplantation, which are dependent on donor tissue and skilled surgical expertise. In this study, we demonstrate that an extracellular matrix (ECM)-based tissue engineering strategy can offer a viable, minimally invasive alternative for KC management. By injecting a decellularized corneal matrix (DCM) hydrogel into the stromal pocket, we achieved localized thickening of the cornea and successful integration with native stromal tissue. Over time, the hydrogel remodeled into a transparent structure, restoring corneal uniformity. This injectable approach requires minimal surgical skill, reduces recovery time, and significantly lowers treatment costs. The DCM hydrogel can be prepared from discarded animal or human corneas obtained from authorized abattoirs or eye banks, providing a sustainable and cost-effective biomaterial source. The commercial-scale production of such injectable corneal tissue hydrogels offers a promising global solution for treating keratoconus and related ectatic disorders, potentially reducing dependence on donor corneas and enabling a no-profit, no-loss model for equitable access to vision-restoring therapies.