Corneal endothelial disease

Endothelial cells treated with magnetic nanoparticles have been injected into humans to successfully treat corneal oedema, Jeffrey L Goldberg MD, PhD reported at AAO 2020 Virtual. In a study of 21 patients, most with end-stage endothelial disease, nine patients gained three or more lines of best corrected vision and none lost any lines or suffered serious adverse events, Dr Goldberg reported. Two of the 21 developed mild transient IOP rise while 14 had significant reduction in corneal thickness. The treatment involves injecting 270,000 cells in a five-minute clinic procedure. They are produced by expanding human corneal endothelial cells in culture, with a single donor corneal yielding enough cells for hundreds of patients, addressing the donor supply issue. Donor cells are then combined with magnetic nanoparticles and injected into the anterior chamber. A magnetic eye patch worn for one hour up to overnight pulls the cells toward the cornea, facilitating localisation and integration into the endothelial layer. In addition to greatly reducing need for donor corneas, the process will reduce the need for highly skilled surgeons to perform DSAEK and DMEK procedures, Dr Goldberg noted. General ophthalmologists will be able to receive and inject the magnetic cells in their clinics, increasing the provider base by 10 to 20 times, while enabling earlier treatment. “We can move from surgery to cell therapy and address a much larger patient base.” The FDA has approved an application to go forward with phase 1b trials in the USA, which are scheduled to commence in early 2021.

Tags: corneal endothelial disease, AAO Virtual 2020