Ophthalmology: Cellular therapy instead of corneal transplant to prevent blindness

Cellular therapy is close to being approved as a treatment for corneal blindness caused by endothelial dysfunction, which is caused by diseases affecting the innermost layer of the cornea. This revolutionary methodology has been highlighted by a study published in the journal Nature Biotechnology, discussed by specialists from the Italian Society of Ophthalmological Sciences (SISO) and the Italian Association of Ophthalmologists (AIMO) at their joint national congress, which concludes today in Rome. "Corneal blindness is a leading cause of vision loss, affecting approximately 10 million people worldwide each year," says Vincenzo Sarnicola, a transplant expert, visiting professor at many international eye clinics, and a member of the SISO advisory board. "The cornea, the transparent tissue that forms the front of the eye, is essential for allowing clear images to enter the eye. When damaged, it becomes opaque, turning the world into a constant fog." While full-thickness corneal transplants from donors and lamellar transplants have restored vision for millions of people worldwide, in developing countries—where transplant tissue is lacking—the upcoming cell therapies for endothelial diseases, which account for approximately 50% of corneal vision loss, could be of great help. "The technique will be very simple: an injection into the eye will allow the injected cells to restore transparency to a cornea that has become opaque due to endothelial dysfunction," Sarnicola emphasizes. "Where are these cells obtained, who can donate, who is the best donor, and what results can be achieved? These are the recurring questions. The results to date (the third phase of trials is underway in North America) show that the best donors are young people under 30. It is hypothesized that hundreds of injections could be prepared from a cornea from a young donor," perhaps even a thousand, says the expert. “Regenerative cell therapies therefore represent the true new frontier for the treatment of corneal endothelial blindness,” concludes Vito Romano, associate professor of Ophthalmology at the University of Brescia.