Automating tissue preparation for donor corneas
- Type of funding: Fight for Sight Small Grant Award
- Grant Holder: Mr Maninder Bhogal
- Institute: Moorfields Eye Hospital NHS Foundation Trust
- Region: London
- Start date: June 2013
- End Date: November 2013
- Eye Category:
Most corneal transplant operations in the UK are due to problems with the cornea’s inner layer (the corneal endothelium). The cornea is the clear front surface of the eye.
About 1000 transplants are done each year. This used to mean that the whole cornea was removed from the patient and replaced with one from a donor. But more recently it has only involved removing some of the inner part as this is easier, safer and more reliable.
In this project the research team is trying to improve the surgery even more. There is a trade-off between two versions of the partial transplant. It’s easier to prepare the donor tissue and do the surgery using one method, but the results aren’t as good as they could be.
The second method leads to faster recovery times, clearer vision and fewer graft rejections. But the tissue has to be disected by hand, which is tricky, and the surgery itself is harder.So Mr Bhogal and team are finding out whether tissue preparation can be automated using a laser. They’re also looking at ways to rate the quality of donor tissue and how the tissue is stored and inserted. The aim is to work out a useful automated technique that can be adopted by eye banks, so that well-prepared donor tissue is available to be sent to surgeons around the UK.
Research updateThe team has developed a laser dissection technique that lets them produce grafts that are less likely to trap fluid, which is one cause of graft failure. This should mean that patients need to have fewer procedures done to make the transplant a success. They are now making sure that the grafts are safe to transplant into patients, which is the last step before the technique can start being used in practise.
- Bhogal, M., Balda, M. S., Matter, K. & Allan, B. D. Global cell-by-cell evaluation of endothelial viability after two methods of graft preparation in Descemet membrane endothelial keratoplasty. Br J Ophthalmol bjophthalmol-2015-307534 (2016).
- Bhogal, M., Maurino, V. & Allan, B. D. Use of a single peripheral triangular mark to ensure correct graft orientation in Descemet membrane endothelial keratoplasty. Journal of Cataract & Refractive Surgery 41, 2022–2024 (2015).