Professor Evelyn Yim’s research group advances the understanding and potential treatment of Fuchs endothelial corneal dystrophy (FECD), a leading cause of blindness and corneal transplants.
Alternatives to surgical transplants, such as injecting healthy cells directly into the eye or using medication, are urgently needed due to a shortage of donor corneas.
The cornea is a clear, dome-shaped protective membrane at the front of the eye, and its transparency is essential for vision.
FECD results in the formation of tiny bumps on the innermost surface of the cornea. These bumps cause the progressive loss of human corneal endothelial cells (HCECs) that act as pumps, constantly clearing excess fluid from the cornea to keep it transparent.
When the cornea becomes cloudy, the condition is in an advanced stage. The study aims to understand the disease mechanism to develop better alternative treatments.
The research demonstrates that these tiny bumps are not merely a symptom of FECD, they actively contribute to HCECs cell loss. The bumps create mechanical stress that stretch the nearby cells, causing them to contract and die.
This mechanical stress poses a challenge for cell injection therapies. Even if a doctor injects healthy HCECs into a patient's eye, those newly injected cells still face the pressure of the existing bumps and could die the same way.
The study revealed that the bumps have a direct effect on the cell death, and the bumps are inducing the cell death by creating a mechanical stress on the cells. Finding the mechanism could help to develop future alternative treatments.
It is difficult to study the disease in vivo, meaning studies conducted on animals because there are no animal models available to study FECD.
To address this problem, researchers built a tissue‑like in vitro lab model, meaning research conducted outside a living organism, using healthy donor cells and patient-derived cells, reproducing the disease’s structure on polystyrene to study the effects of the bumps.
The research group included Dr. Stephan Ong Tone, a corneal surgeon from Sunnybrook Research Institute in Toronto alongside Dr. Gary S.L. Peh and Dr. Jodhbir S. Mehta from the Singapore Eye Research Institute in Singapore.
“This could help to improve alternative treatments and might mean fewer people will need corneal transplants in the future,” says Yim, a Canada Research Chair in Nanomaterials for Regenerative Medicine.
The study, Corneal guttata-like microtopography induces corneal endothelial cell apoptosis by modulating mechanotransduction was recently published in the journal Cell Biomaterials.