Novel Chemical Crosslinking of the Cornea for Treatment of Keratoconus

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The Aravind Eye Care System in Southern India was established as a health care model that could supplement the efforts of the government and also be self-supporting to overcome the problem of avoidable blindness in a developing country. The company Aurolab is an integral part of the Aravind Eye Care System. It manufactures a wide range of high quality ophthalmic consumables. Developing a translational alliance with the Aravind Eye Care System and Aurolab will provide us with the opportunities to gain access to a commercial infra-structure which includes support for polymer technologies and manufacture, product commercialisation in terms of regulatory approvals, IP protection and advertising, as well as distribution and labelling. Aurolab's products are exported to 130 and more countries worldwide and their products meet the regulatory requirements of the USA, EU and WHO. All Aurolab products are manufactured on efficient production lines with strict quality assurance measures. We intend to develop this translational alliance with Aurolab and the Aravind Eye Care System to exploit our novel chemical cross-linking therapy for the treatment of keratoconus. Keratoconus is a progressive condition, often affecting young and working age people, in which the cornea becomes misshapen significantly disrupting the refraction of light into the eye. One of the key features of keratoconus is a loss of corneal mechanical stability. Increasing the stiffness of the cornea can reduce the progression of this debilitating eye disease. Corneal collagen cross-linking focuses on stiffening the cornea in order to preserve corneal integrity due to strong bonds formed within the collagen. Using our understanding of the engineering principles that define the relationship between the structure and mechanical properties of materials we will develop a novel collagen cross-linking therapy using di-carboxylic acids thus this proposal lies clearly at the interface between Engineering and Healthcare Technologies and aligns closely with the Synthetic Biology for Health area.To establish the partnership we will make multiple visits to India regularly over the 2 years of the project. We will also host visits from senior scientists and clinicians from India. In particular we will host a 3 month research exchange for a Product Development Scientist from Aurolab to learn about our research and facilitate a research exchange for our PDRA to spend 3 months at Aurolab to learn about product manufacture and scale up. We will jointly supervise a clinical research fellow at the Aravind Eye Care System and we will establish an in vivo animal model facility in Liverpool which will support this project and future development projects as part of the long term partnership. These other project areas that would benefit greatly from the alliance could lead to translational opportunities and impact to the health and wealth of societies in the UK and globally. By working together to design these projects we will ensure that they address the clinical and commercial requirements for India, the UK and globally. Specific examples could include the extrapolation of the cross-linking therapy to the development of a strategy to increase the mechanical properties of ulcerated cornea to protect against perforation and aid healing and the potential to increase the stiffness of the sclera as a treatment for myopia and/or glaucoma. A further area of particular interest to our project partners is the development of bandage contact lenses with the potential to deliver anti-fungal agents such as voriconazole for the treatment of fungal keratitis which is a major clinical problem in India. In the more longer term there are several projects within the Department of Eye and Vision Science at the University of Liverpool that would benefit from this alliance such as the development of drug delivery devices for the front and back of the eye.