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Based on stem cell research he helped finish at the University of Pittsburgh School of Medicine, Indian ophthalmologist, Sayan Basu, is utilizing stem cells in a test project to restore the vision of patients with damaged corneas. The stem-cell procedure was first described only last month in the journal ‘Science Translational Medicine’ and has made record time in making the transition to treatment for humans. If the trial is successful, further implementation could mean that Indian citizens would be able to avoid long lists for traditional corneal transplants and be spared eye surgery completely.
In the original Pittsburg study, stem cells were gathered from tiny biopsies in the limbus, an area of the eye between the cornea and sclera – the white part – of the undamaged eye of mice. Those stem cells were replicated in a lab and then incorporated into a gel of fibrin, a protein found in blood clots and often used as a surgical adhesive. In the final step, the gel was spread on the damaged cornea. Within four weeks, the stem cells regenerated a clear window to the eye.
Though a comprehensive report won’t be available till spring, the most recent results from Dr. Basu’s application of this process with human test subjects show promising results. The scarred corneas of ten patients have been successfully repaired. “The uniqueness of this trial,” Basu comments, “is that we are using cells from the patients’ own eyes to treat the cause of blindness.”
For over a hundred years, corneal transplants have been the conventional method used to repair damaged and diseased corneas; however, the wait for donor corneas in many parts of the world can be extremely long. Once a donor cornea is available, surgery is required to replace the damaged cornea or corneal layer and replace it with a healthy one. After surgery, the transplant patient must endure long post-surgical follow up care, a regimen of life-long medications, and even a small chance that their body will reject the donor. The stem cell transplant procedure, in contrast, is non-surgical, necessitates only a mild anesthetic, and drastically reduces any chance of rejection.
The United States is privileged enough to have 80 eye banks that adequately meet national demand and is able to even send some 21,000 corneas overseas to nations that are under stocked. One of the reasons for the disparity in supply might be found in the fact that 90 percent of the global cases of ocular trauma and corneal ulceration leading to corneal blindness occur in developing countries and are caused by vitamin A deficiency, infections, and injury. In India, 200,000 people with corneal blindness would benefit from transplants, but there are only corneas available for 10 – 20,000 people each year.
Whereas in the U.S, the stem-cell innovation faces a long process of human clinical trials, FDA investigation, and unclear market pressures, there is also not the same urgency to put it in action. As for India, and many other developing countries, the fruit of Dr. Basu’s findings could make a big difference. With the approval of India’s Instituitional Review Board and Institutional Stem Cell Committee, he has begun performing stem-cell procedures on people at the LV Prasad Eye Institute in Hyderabad in south-central India with great hope and excitement.
