Good results in bullous keratitis after grafting of corneal endothelial cells
20.09.2021
In a pilot study with 11 people, the bullous keratitis of the cornea of the eye was successfully treated by transplanting endothelial cells from a donor while simultaneously administering the Rho-associated protein kinase to the anterior chamber, and vision was improved by two lines after 24 weeks.
Some diseases of the cornea of the eye are caused by dysfunctional endothelial cells. This is also the case with Fuchs endothelial dystrophy, where insufficient humidification leads to clouding of the cornea, blistering (bullous keratitis) and loss of vision. The standard therapy would be a corneal transplant. With the transplantation of endothelial cells, the authors hope for a less invasive procedure.
The study with 11 people diagnosed with bullous keratitis and a complete loss of endothelial endothelial cells was carried out without control. The cells were taken from the cornea of a young donor, cultivated in the laboratory and, together with an inhibitor of Rho-associated protein kinase (ROCK), injected into the anterior chamber after the remnants of the degenerated endothelial cells had been scraped away. The primary study objective was to restore corneal transparency to a density of at least 500 cells per square millimeter in the center of the cornea 24 weeks after surgery.
Half a year after the operation, the targeted minimum density of 500 cells per square millimeter in the center of the cornea was achieved in all 11 recipients. In 10 recipients, the density was over 1000 cells / square millimeter.
The secondary study goal of a corneal thickness of less than 630 µm was achieved for 10 of 11 transplant recipients.
The second secondary study objective, an improvement in vision in the treated eye by at least two lines, was achieved in 9 of 11 patients.
This pilot study was successful but only had 11 patients. It is a first step towards a comparatively simple and less invasive procedure that could replace corneal transplantation as a therapy for endothelial dystrophies if independent replication is possible and long-term side effects can be ruled out with greater certainty.
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