EyeWorld India March 2018 Issue

March 2018 EWAP FEATURE 23 Corneas of rabbits receiving tissue engineered graft in tissue engineered endothelial keratoplasty group swelled to almost 1,000 µm by day 4. Corneal thickness recovered to just under 400 µm by week 3. Corneas of rabbits receiving dose of corneal endothelial cell injection increased in corneal thickness slightly at day 4, but gradually thinned down to just under 500 µm thick by week 3. Control rabbit corneas had thickness of about 400 µm to 425 µm and did not cross-react when stained with anti-human nuclei antibody. Source: Jodhbir Mehta, MD At this point, Dr. Mehta said clinical trials have been approved for cultivated endothelial cells on a carrier and will soon begin enrolling. Separately and only for Fuchs’ patients, Dr. Mehta described research with regenerative therapy, where the patient’s own Descemet’s membrane is removed and replaced with an acellular donor Descemet’s that had endothelial cells removed. The patient’s own endothelial cells at the periphery then migrate over the donor Descemet’s, which is acting as a scaffold but also pre- vents stromal cell migration to the posterior. Dr. Mehta said replacing with an acellular Descemet’s rather than stripping and leaving without a graft resulted in better recovery in a rabbit host. 16 EWAP References 1. Terry MA. Endothelial keratoplas- ty: history, current state, and future directions. Cornea . 2006;25:873–8. 2. Gain P, et al. Global survey of corneal transplantation and eye banking. JAMA Ophthalmol . 2016;134:167–73. 3. Agarwal A, et al. Pre-Descemet endothelial keratoplasty with infant donor corneas: a prospective analy- sis. Cornea . 2015;34:859–65. 4. Agarwal A. Pre-Descemet’s en- dothelial keratoplasty (PDEK). New Delhi, India. Jaypee Brothers Medi- cal Publishers. November 2017. 5. Balachandran C, et al. Spontane- ous corneal clearance despite graft detachment in Descemet membrane endothelial keratoplasty. Am J Oph- thalmol . 2009;148:227–234. 6. Arbelaez JG, et al. Long-term follow-up and complications of stripping Descemet membrane without placement of graft in eyes with Fuchs’ endothelial dystrophy. Cornea . 2014;33:1295–9. 7. Koenig SB. Planned Descem- etorhexis without endothelial keratoplasty in eyes with Fuchs’ cor- neal endothelial dystrophy. Cornea . 2015;34:1149–51. 8. Okumara N, et al. Effect of the rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothe- lial wound healing. Invest Ophthal- mol Vis Sci . 2016;57:1284–92. 9. Borkar DS, et al. Treatment of Fuchs’ endothelial dystrophy by Descemet stripping without endothelial keratoplasty. Cornea . 2016;35:1267–73. 10. Moloney G, et al. Descem- etorhexis for Fuchs’ dystrophy. Can J Ophthalmol . 2015;50:68–72. 11. Moloney G, et al. Descem- etorhexis without grafting for Fuchs’ endothelial dystrophy–sup- plementation with topical ripasudil. Cornea . 2017;36:642–648. 12. Peh GS, et al. Cultivation of human corneal endothelial cells isolated from paired donor corneas. PLoS One . 2011;6:e28310. 13. Numata R, et al. Cultivation of corneal endothelial cells on a peri- cellular matrix prepared from hu- man decidua-derived mesenchymal cells. PLoS One . 2014;9:e88169. 14. Mimura T, et al. Treatment of rabbit bullous keratopathy with precursors derived from cultured human corneal endothelium. Invest Ophthalmol Vis Sci . 2005;46:3637– 44. 15. Tan T, Peh GS, George BL, Cajucom-Uy HY, Dong D, Finkel- stein EA, Mehta JS. A cost-minimi- zation analysis of tissue-engineered constructs for corneal endothe- lium transplantation. PLoS One . 2014;9(6). 16. Bhogal M, Lwin CN, Seah XY, Peh G, Mehta JS. Allogeneic desce- ment’s membrane transplanta- tion (DMT) enhances endothelial monolayer formation and restores functional integrity following descemet’s stripping. Invest Ophthalmol Vis Sci. 2017. Editors’ note: Dr. Mehta has a patent on the culture media used for cultiva- tion of human corneal endothelial cells. Dr. Agarwal and Dr. Colby have no financial interests related to their comments. Contact information Agarwal: dragarwal@vsnl.com Colby: kcolby@bsd.uchicago.edu Mehta: jodmehta@gmail.com