Eyeworld

64 | EYEWORLD | OCTOBER 2020 C ORNEA Contact Basu: sayanbasu@lvpei.org Djalilian: adjalili@uic.edu they are conducting the first human trials using these cells for treating visual impairment and blindness due to stromal pathologies. Dr. Djalilian said that treatment with MSCs is still highly experimen- tal, and there is very limited data and experience from patients. Completed studies are mostly in animal models, and human patients are just beginning to be tested. India is the only place that has gotten as far as testing in hu- man patients; U.S. testing in humans may start later this year, he said. The basic idea is that this could be used for corneal scars that are more superficial, Dr. Djalilian said. It may be possible to get the tissue in that area to remodel so that it then gets replaced by a clearer corneal stro- ma, without removing any tissue. Another way it could be applied, he said, is when there is a deeper scar in the cornea; remove the tissue and replace it with these cells. Instead of having to transplant corneal tissue, you use a combination of cell and matrix to replace the cornea, Dr. Djalilian said. He added that this has not yet been tested in humans and may be something that could be used in the future. Conditions causing corneal scarring that would require stem cell transplantation Dr. Djalilian said that this treatment could be used for any type of condi- tion that has scarring in the cornea, but primarily scarring that's more anterior. Deep extensive scarring or scarring on the whole cornea cannot be treated adequately with current treatment options, he said. The other conditions where it might be use- ful, he said, are conditions where there's active inflammation. Corneal scarring or fibrosis is caused by inflammation or trauma involving the corneal stroma, Dr. Basu said. "Corneal scarring is the leading cause of visual impairment or blindness due to corneal diseases," he said. He added that in developed countries, post-refractive surgery haze, herpetic infections, and contact lens-re- lated infections are the major cause of corneal scarring. Meanwhile, in most of the developing world, trauma or corneal injury followed by continued from page 62 Relevant disclosures Basu: None Djalilian: None Injuries to the cornea can induce the production of inflammatory cytokines (A). Application of MSCs to the cornea inside a fibrin gel can modulate inflammation through the secretion of immunomodulatory factors (B). Source: Ali Djalilian, MD continued on page 66

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