New and emerging treatments for corneal disorders

Fight for Sight has teamed up with the Horizon Scanning Research and Intelligence Centre again to address another top priority for eye research as identified by the people most affected by sight loss. This time we looked at new and emerging treatments for conditions that affect the cornea – the clear front surface of the eye.

The report found 130 upcoming technologies and procedures. Together, they have the potential to help thousands of people with conditions that affect the shape of the cornea, such as keratoconus.

Little on the horizon for severe conditions

But it was clear that there is a lack of emerging treatments for the main reasons for corneal transplants and main causes of sight loss in corneal disorders. These are conditions that affect the inner layer of the cornea, such as Fuchs dystrophy.

At the moment the only way to treat severe corneal disorders is by surgery to transplant a donor cornea. The UK Transplant Registry recorded almost 4000 of these operations in 2015-16.

However there is a shortage of donors and transplants mean patients must take drugs for the rest of their lives to prevent the transplant from being rejected. So there is a real need for more options and we wanted to find out what they might be.

Setting priorities for eye research

The top priority for research on corneal disorders as identified by the Sight Loss and Vision Priority Setting Partnership (PSP) was to find out whether new therapies such as gene or stem cell treatments can be developed. The current horizon scan took place to try to address this question.

The Horizon Scanning Research and Intelligence Centre is part of the National Institute for Health Research (NIHR). They searched a wide range of sources including scientific publication databases, clinical trial registries, industry news sites, licensing bodies and ophthalmology organisation websites.

They also contacted clinical experts to suggest any new developments they were aware of, and for their opinion on what NIHR found. We also got feedback from people with corneal conditions before the final report was written.

Tracey Genus, Analyst at NIHR HSRIC said:

“It’s clear that a wide range of technologies for corneal disease is under development at the clinical stage. However many are in development outside of Europe and may take time to reach the NHS, if indeed they do.

“And while there were plenty of developments for astigmatism, more needs to be done to address conditions such as Fuchs endothelial dystrophy and post-cataract surgery corneal oedema. These are major causes of sight loss and of the need for corneal transplant. Around 1 in 3 and 1 in 5 transplant surgeries respectively are due to these conditions.”

Safety and risk

Carol Bewick is Fight for Sight’s Director of External Affairs. She said:

“We have learned from the focus groups on corneal disorders that safety, immediate- and long term risk to sight and risk of rejection are the key concerns for patients. This is something that everyone developing technologies needs to keep in mind.

“The Sight Loss and Vision Priority Setting Partnership was all about making sure that eye research can address the questions that are most important for the people who experience visual impairment every day. We think it’s vital to keep that involvement going as we try to answer the PSP questions.”

The full report is available on the NIHR website or here as text, or you can download a 2-page summary of the report (PDF) (text).