The fate of the corneal endothelium during storage: apoptosis/necrosis/survival

Cell death during corneal storage is, at least with current methods, inevitable. There are also concerns with a tissue such as cornea for the maintenance of cell‐cell and cell‐matrix interactions that are so vital for overall physiological function of the tissue. The reversibility of such changes is clearly of fundamental importance. However, once cells are committed down a pathway of cell death, there is perhaps little that can be done to reverse this process. The terminology applied to describe cell death perhaps clouds our perception and too easily leads us to categorize cell death simply as apoptosis or necrosis. In particular, the term necrosis merely describes an end point and sheds no light on the mechanism by which a cell died, for example by oncosis. Understanding the mechanisms and pathways to cell death may, however, provide insights into novel targets for supporting cells, reducing cell loss, and improving functional integrity.