Aging populations are therefore expected to worsen the worldwide shortage of transplantable corneal tissue. Particularly in Asia, where donor retrieval rates are lower than the USA, this shortage is likely to be more acute. Such projections have engendered significant interest in alternative sources of transplantable corneal tissue. Tissue engineering is the use of cells and materials to produce functional substitutes for damaged tissue or organs. Application of tissue engineering for the corneal endothelium is attractive for two main reasons: First, corneas are the most transplanted organ worldwide. Second, tissue-engineered corneal epithelial constructs are already in clinical use. Tissue-engineered constructs comprising a monolayer of human corneal endothelial cells, expanded within an in vitro environment, and seeded onto a membranous scaffold carrier should theoretically function as viable substitute graft material equivalent to precut EK donor tissues. Recent advancements in reproducible culture of HCECs and improvements in surgical techniques like DSEK/DMEK have made the clinical application of such tissue-engineered endothelial constructs a realistic possibility. In fact, clinical success of transplanted tissueengineered endothelial constructs has already been demonstrated in a primate model. Performing EK with tissue-engineered endothelial constructs is within reach. However, whether or not it is economically viable remains an open question. Cost-minimization analysis is a form of pharmacoeconomic analysis that measures and compares the costs of two competing approaches that are assumed to provide equivalent outcomes. This paper uses cost-minimization analysis to assess the economic feasibility of performing EK with tissue-engineered constructs, from the perspective of an ophthalmic institution in Singapore that GSI-IX possesses the surgical Rapamycin expertise to perform EK, but is lacking established infrastructure for the acquisition of transplantable EK tissue. It was assumed that one pair of corneas arrived every fortnight, and took weeks to culture. Pairs of corneas at different stages of the protocol could be cultured simultaneously.