The cornea is the transparent windshield of the eye. In order to see well, it must be free of vessels and inflammatory cells. If blood or lymphatic vessels sprout in the course of inflammation, the transparency decreases and the patient may need a corneal transplant. Corneal opacities are the second most common cause of blindness worldwide.
Corneal transplants in corneas free of blood vessels have a very good prognosis. However, if pathological blood vessels are present in the cornea, the risk of rejection increases from 10 to over 50%. There is still no effective therapy or prevention for this. The University Eye Hospital Cologne and the DFG Research Group 2240 have done groundbreaking preliminary work to improve graft survival in corneal transplantation in vascularized high-risk eyes. In preclinical and initial clinical studies, the group led by Prof. Cursiefen, Director of the Department of Ophthalmology was able to show that regression of blood and lymphatic vessels and a reduction in the number of inflammatory cells in so-called high-risk eyes prior to transplantation using UV light significantly improves subsequent graft survival.
In order to transfer this new concept of “lymphangioregressive preconditioning” into the clinic, the German Federal Ministry of Education and Research (BMBF) supports a multicenter, prospective, randomized pilot study over a course of 5 years, which is coordinated by the Cologne University Eye Hospital and the ZKS Cologne. The aim is to investigate whether UV-light mediated corneal crosslinking as a lymphangioregressive pretreatment improves graft survival after subsequent high-risk corneal transplantation. For this propose, multiple centers are studying graft survival in pretreated versus non-pretreated patients.
“This would be the first innovation to improve graft survival in high-risk eyes in decades and a real milestone” said Prof. Cursiefen the project leader. The study is closely related to preclinical work conducted as part of DFG Research Group 2240 at the University Eye Hospital in Cologne. Most of the corneal transplantations in Germany in 2021 were performed at the University Eye Hospital in Cologne, most of them as minimally invasive lamellar keratoplasties.
More information at www.dmek.de.
