As part of an ongoing Indo-Japanese research initiative, the transport of the endothelial cells of the cornea at normal temperatures without cool preservation has now been made possible in Chennai.
This feat, an internationally first of its kind, of viable transportation of corneal endothelial tissue, without any cool preservation, has been accomplished jointly by ophthalmologists from all over India associating with Nichi-In Centre for Regenerative Medicine (NCRM), an Indo-Japan academic institute based in Chennai.
The time, from harvesting the corneal endothelial tissue (from cadaver donor-eye) to reaching a central stem cell lab was up to 72 hours, and due to the unique nanopolymer cocktail used for the transportation, the cells have survived.
Cornea, the transparent front portion of the eye, which transmits the images into the eye for visual perception, when damaged, may need to be transplanted with a cornea from a deceased donor. The cadaver cornea should be harvested within six hours from the death of the donor and be preserved in specialized media under cool conditions to be transplanted within two weeks to a needy patient. Cornea has three main layers, the outer epithelium, central stroma and the inner endothelium. In today’s practice, the eyeball is harvested and if the cornea is of usable quality, then it is preserved and transported in cool conditions to the needy patient’s place where the cornea is removed and transplanted.
In the present study, from the eyes which were not suitable for such transplantation, the endothelium alone was separated and transported in a nanopolymer cocktail from hospitals in Dharmapuri (TN), Mumbai and Sirsa (Haryana) to the NCRM lab in Chennai and the team at NCRM could successfully isolate viable cells from these.
In India approximately 1.5 lakhs corneas are needed for transplantation every year, whereas only a small portion of this is made available, leading to a huge backlog of patients waiting for the same and going by the statistics. The total number of corneal blind population is expected to cross 10.6 million in the year 2020. According to the eye transplant registry of Asian countries, one-third of such patients have total corneal diseases requiring full thickness corneal transplantation and in the remaining two-third, half of them have stand-alone endothelial disease, which could be treated with endothelial transplant.
“It was Dr Shiro Amano of Tokyo University, Japan, who first identified that human cadaver endothelium, has precursor cells and guided the NCRM team with the culture technique. However the major hurdle was the transportation of the cadaver eye-derived corneal endothelium from the place of harvesting to the lab in Indian conditions because the corneal endothelial cells are very sensitive and fragile,” said Dr Abraham, director of the institute.
The nano-polymer based cocktail prepared by NCRM in collaboration with Prof. Mori of Waseda University has proven that the corneal stem cells could be transported from even faraway places without any cold chain preservation in the varying climatic conditions of India. This “an-eye-for-eyes” mission has taken close to eight full years to see the light and this day is very significant to us as eight years ago on the same day NCRM was inaugurated in India, said Dr Abraham. He said with this technology we can retrieve the stem cells from corneal endothelium even in the eyes which are otherwise not usable for transplant and help save the vision of patients waiting for transplantation. He recommended that similar studies be done in transporting the full thickness cornea to see if we can prolong its shelf life.