Creation of bio-synthetic corneal endothelial grafts for transplantation

Overview

The innermost layer of the cornea is a single layer of cells called the endothelium whose main function is to pump fluid out of the cornea preventing it from swelling and losing transparency. In some diseases, the corneal endothelium is abnormal or damaged and does not function properly leading to corneal swelling and loss of vision. Currently the only treatment for this problem is removal of the damaged layer and replacement with a new layer from a corneal donor. There is a global shortage of cornea for transplantation so cultured endothelial therapies are the future for this field.

The expansion of corneal endothelial cells in the laboratory onto a suitable material will enable the creation of bio-synthetic endothelial grafts. Several bio-synthetic endothelial grafts will be produced from each human donor cornea so patient waiting times for this sight saving operation will be reduced.

The challenge is to develop a material that supports the endothelial cells to form a functional layer, but which also has the physical properties that enable it to be handled easily by the surgeons for transplantation.

The researchers have combined the expertise of materials scientists, engineers, chemists and biologists to develop a novel gel material with superior mechanical and optical properties that has the potential to form the basis of an ideal corneal endothelial graft. The next step along the pathway to the clinic will be to test whether their bio-synthetic graft functions adequately in a model of damaged endothelium.

If the results of this study are favourable then it suggests that it would be feasible to pursue the development of their technology as a new therapy for corneal endothelial disease.

This would produce a major advancement of the technology towards the clinic and could mean that a first in human trial would be possible within 5-7 years. Fuchs’ endothelial corneal dystrophy and pseudophakic bullous keratopathy patients would be the first to benefit from decreased waiting times for sight saving operations.