An expansive EU project to produce an artificial cornea has found success thanks to the work of Joachim Storsberg of the Fraunhofer Institute for Applied Polymer Research IAP in Germany. Storsberg helped develop a new version of an opthalmological polymer which the eye will bond to and still allow to function properly. The new polymer could help restore sight to thousands waiting for corneal transplants around the world. The artificial cornea has passed clinical trials and is ready to see expanded use in patients this year. Very soon those with corneal blindness may find a ready cure in the form of the new implant.
Corneal blindness affects millions around the world. According to the WHO, about 5 million cases of blindness in the world (as of 2001) were a result of corneal damage or dystrophy. We’ve seen several high-tech approaches to fighting corneal blindness including the application of embryonic stem cells to generate new tissue. For most of those affected around the world, however, corneal transplants represent the surest and most accessible treatment for their condition. A readily accessible, easily made artificial cornea is a huge boon to corneal transplants.
More than one hundred thousand patients wait for corneal transplants each year (~40k in EU, another 40k in the US, and many more around the world). While such transplants are fairly routine and regularly successful operations, they require the donation of the tissue from another human being, almost always someone recently deceased. The artificial cornea not only eases the pressure on finding enough donors for recipient needs, it also provides the opportunity for hospitals to increase the speed and availability of such treatments. Ideally, no one will ever have to go without a new cornea ever again.
In order to work in the human body, an artificial cornea has to meet some rather stringent requirements. First, it has to bond to the human eye around its edge, but stay unclouded by cells in its center. To that end, Storsberg took a widely used opthalmological polymer (found often in intraocular lenses) and adapted it with other special polymers around the edges. Combined with the application of a growth factor protein, the modified edge promoted cell growth around the periphery of the implant and secured it in place using the body’s own cells. The center of the artificial cornea, however, does not promote cell growth and remains clear so that it can be seen through. The artificial cornea also has to move freely with the eyelid and balance moisture on its faces. The polymer Storsberg chose is hydrophobic, allowing tears to lubricate the surface and provide the correct moisture on both of its sides.
Storsberg’s work was part of a larger EU funded endeavor, the Artificial Cornea Project, which sought to create a non-human based replacement for damaged corneas. The Artificial Cornea Project took three years, and the work of many collaborators around the continent, to produce the new implant. Miro GMBH handled the actual production of the material. Animal trials in pigs and rabbits were successful and lead to the first human uses in 2009. Those early human cases showed enough success to get EU approval for the device and the artificial cornea is expected to see its first widespread use sometime in 2010. That’s very exciting news. This project has not only succeeded, but the fruits of its labor are about to be (readily?) available to patients throughout the EU very soon.
A non-degrading piece of plastic permanently grown into your eye does not sound like the most elegant solution to the problem of corneal blindness, especially when regeneration of tissue through stem cells is on the horizon. But the artificial cornea is a solution which is (almost) available NOW. That’s immensely important. As with so many other current endeavors in medicine, curing blindness is likely to see a staged series of solutions using various emergent technologies. Artificial materials and implants in the near term, autologous stem cells in the far term, and DNA based solutions in the very far term. We need all of these solutions to help transition into a time when blindness is no more of medical hurdle than a broken bone. I wish nothing but the best of luck to Storsberg and the rest of the large team from the Artificiail Cornea Project. With their help I think we are continuing our journey towards an age when medicine can regenerate or replace absolutely any part of your body. Check off “building new eyes” on the list of requirements for immortality.
[image credits: Artificial Cornea Project, Fraunhofter/Dirk Mahler]
[source: Fraunhofer Press Release, Artificial Cornea Project, National Institute of Health]
