Evaluation of fibrin membrane-embedded adipose-derived mesenchymal stem cells for corneal repair in a rabbit corneal alkali-burn model

Abstract To investigate the reparative potential of fibrin membranes enriched with adipose-derived mesenchymal stem cells (ADMSCs) for addressing corneal injuries in a rabbit model of alkaline burns. This controlled experimental study utilized a preclinical rabbit model to evaluate corneal repair strategies. Twenty-one New Zealand White rabbits were allocated into three groups: Group A (fibrin membranes with ADMSCs), Group B (acellular fibrin membranes), and Group C (untreated controls). Alkaline corneal burns were induced in the left eye of every rabbit on Day 0 following a standardized protocol, and animals were allocated to the three groups on Day 14, once corneal neovascularization had developed. Therapeutic efficacy was assessed through histopathological and immunohistochemical evaluations, focusing on epithelial regeneration, attenuation of inflammation, reduction of neovascularization, and reorganization of stromal collagen fibers. On ordinal histological grading, the three-group overall tests were significant for all outcomes assessed. Epithelial degeneration was absent in all 7 rabbits in Group A but present in all rabbits in Groups B and C (P = 0.000026). Neovascularization (P = 0.00012), stromal inflammation (P = 0.0017), collagen organization (P = 0.00012), and vimentin-positive stromal cell staining (P = 0.0038) also differed significantly among the three groups. Corneal melting was recorded in 1 of 7 rabbits in Group A, compared with all rabbits in Groups B and C (P = 0.00039). In pairwise comparisons after Holm adjustment, Group A differed significantly from Group B for epithelial degeneration, neovascularization, collagen organization, corneal melting and vimentin staining; the Group A versus Group B difference for stromal inflammation did not reach significance after adjustment (adjusted P = 0.077). In this rabbit corneal alkali-burn model, treatment with an ADMSC-seeded fibrin membrane was associated with more favorable terminal histological outcomes than the comparator groups, including improved epithelial integrity and lower grades of neovascularization and corneal melting. Because the study used terminal ordinal histological endpoints, a 14-day post-treatment observation window, and no uninjured normal-cornea comparator, these findings should be regarded as preliminary and require confirmation with molecular outcome measures, longer follow-up, and larger studies before clinical translation.