New approaches to corneal transplants
16 August 2023
Our support enabled Moorfields’ recruitment of Saj Ahmad in 2016, advancing corneal research. We back his programme through multiple grants, boosting this critical work.
A key priority of his research has been to take existing work on lab-grown corneal cells further.
He aimed to make strides towards translating this approach from the laboratory into the clinic, which could offer new and better treatment options for patients with conditions affecting their cornea.
A wide range of eye conditions and trauma to the eye itself (for example, as a result of acid attacks) can affect the health of our cornea. One part of the cornea commonly damaged is the inner lining of cells (the endothelium).
While corneal endothelial failure is traditionally treated through a wholesale corneal transplant, recent advances in surgery have allowed clinicians to transplant just the endothelial layer.
This new approach shows lower rejection rates, faster recovery and better patient outcomes than transplanting the whole cornea.
However, the tools and skills to perform endothelial transplants are expensive and in short supply.
Moreover, there is a global shortage of donor corneas for transplantation.
Therefore, Saj set out to better understand how we can grow corneal endothelial cells in the lab, hoping that lab-grown cells could one day be transplanted into patients – offering a powerful new treatment option not dependent on finding a corneal donor!
Growing corneal cells
By growing donor cells from older people on this extracellular matrix, the team successfully grew and then isolated corneal endothelial cells in the lab, offering new promise to the vision of growing these cells for transplantation into patients in the future.
Growing corneal endothelial cells in the lab is notoriously difficult. Saj’s work under the charity’s research support made several new and exciting discoveries that have contributed to progression in this area.
Saj’s team explored the role of extracellular sacs (exosomes) in the growth of these endothelial cells.
They found, for the first time, that these exosomes inhibit the growth of corneal endothelial cells since when they were added, the cells grew more slowly and died at a greater rate than when they were not present.
Looking deeper at why this might be, they discovered 13 molecules (microRNAs) that precisely slow the growth of these cells and encourage cell death.
This offers a new understanding of why these cells are so tricky to grow and maintain in the lab and may help scientists grow them more easily.
This research could have a huge global clinical impact. Growing corneal endothelial cells in the lab would mean that one donated cornea could be used to treat many patients, reducing the worldwide shortage of human donor corneas and lowering the number of patients waiting for a corneal transplant.
After such an exciting and fruitful programme of work, Saj and his team are keen to keep working on understanding how we can best grow human corneal endothelial cells in the lab and, hopefully, one day offer patients a new treatment option to help protect their vision.