Corneal epithelial cell bandage to treat persistent epithelial defect

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Corneal would healing is essential to maintain the integrity of the cornea. In a healthy eye, after an insult to the ocular surface, the epithelial defect is repaired by a complex re-epithelialisation process. Healing may be delayed or halted in compromised conditions leaving the underlying stroma vulnerable to further trauma, infiltrates, infection, scarring and perforation. A persistent epithelial defect is defined as a defect that is not resolved after 2 weeks of standard treatment. There are risk factors that confound corneal epithelial wound healing including diabetic keratopathy, limbal stem cell deficiency, dry eye disease, neurotrophic keratopathy and herpetic infection to name a few. The current treatments for persistent epithelial defect can include lubricating eye drops, punctal occlusion to provide a more lubricious environment, bandage contact lenses, serum, tarsorrhaphy or amniotic membrane transplant. Standard treatments tend to be ineffective, prolonging patient discomfort and diminished visual acuity. Due to the complex nature of the disease, patients must be examined multiple times a week, with some patients requiring up to 90 visits a year. The economic impact of this on health systems is substantial. We are developing an alternative treatment that involves transfer of corneal epithelial cells to the ocular surface directly via a soft contact lens. Our 'cell bandage' will enable rapid healing of the wound by the transplanted cells with the additional benefit provided by the contact lens element of the therapy of the protection from shearing forces that occur when blinking. We have proof of principle that the cell bandage functions to heal wounds in vitro but we need to test its effectiveness in a model using human eyes in the lab and its safety in a whole animal model. If the cell bandage provides favourable results we will continue to develop the product working with cell therapy manufacturers to determine a production method suitable for use in patients.