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Engineering a new future for corneal transplants

Critical research to help combat a global shortage of donated corneas for transplant has received a major boost from the DHB Foundation.

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The DHB Foundation will fund a four-year research fellowship for Dr Karl Brown, from the Centre for Eye Research Australia’s Corneal Research Unit, enabling him to further his research to develop a tissue-engineered corneal endothelium for transplant.

The project, which will trial growing corneal endothelia in the lab using the patient’s own cells, could eliminate the need for donated corneas in transplant surgery and overcome the problem of transplant rejection which occurs in some recipients.

The technology could also enable cells from one donor to be grown into many transplants to help people in countries where there are major shortages of donor tissue.

“More than 10 million people around the world are missing out on sight-saving corneal transplants because they live in countries where there are major shortages of donor tissue,’’ says Dr Brown.

“Eventually, the use of stem cell technology and tissue engineering could eliminate the need for donors to treat corneal endothelial disease allowing the treatment of millions of people worldwide currently blind because of a global shortage of donor corneas.”

A common cause of blindness

 

The cornea is the clear window at the front of the eye which plays a critical role in our vision.

Cells of the corneal endothelium, a fine layer at the back of the cornea, help pump fluids out of the cornea and keep it transparent so that light can pass into the eye, enabling us to see.

When these cells fail because of ageing, trauma or disease – the cornea swells and becomes cloudy, leading to vision loss and blindness.

Around the world, almost five million people are blind in both eyes because of corneal disease, many because of the failure of their corneal endothelium cells.

In Australia about half of all corneal transplant surgeries are performed because of problems with patients’ corneal endothelia.

A new solution

 

Dr Brown works closely with CERA’s Principal Investigator Corneal Research Associate Professor Mark Daniell to engineer a new approach to corneal transplants.

In recent years they have collaborated with colleagues from the University of Melbourne to develop a hydrogel film which helps prevent damage to fragile donor corneal endothelium during transplant surgery.

The next phase of research builds on this technology by adding donor cells to the gel film to grow new corneal tissue.

Importance of eye donation

 

The Lions Eye Donation Service is an important partner in Dr Brown’s research.

“I’m extremely grateful to the families of those who have consented to their eyes being used for research who make our investigations possible,’’ says Dr Brown.

Researchers will also investigate whether corneal endothelial cells grown from induced pluripotent stem cells – which are produced from adult cells – can be incorporated into the engineered corneal endothelium.

If successful, this could create an almost unlimited supply of tissue for transplant.

“Our technology has the potential to restore the sight of millions of people worldwide and transform the treatment of corneal disease for patients who currently rely on donor tissue to treat their condition,’’ says Dr Brown.

“The funding from the DHB Foundation will enable us to take our research to the next level and accelerate the progress of developing new treatments for patients. We are truly grateful for this support.’’

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