A persistent scratch on the eye’s surface that refuses to heal after two weeks of standard treatment leaves the cornea vulnerable to infection, scarring, and even perforation. This condition, called a persistent epithelial defect, can arise from diabetes, dry eye disease, or nerve damage, and current treatments—lubricating drops, bandage contact lenses, or amniotic membrane grafts—often fail, forcing some patients to attend up to 90 clinic visits per year. The researchers are developing a “cell bandage”: a soft contact lens coated with living corneal epithelial cells that is placed directly onto the eye. The transplanted cells should close the wound rapidly, while the lens itself protects the healing surface from the shearing forces of blinking. The team has already shown the bandage heals wounds in lab-grown corneal tissue. They now need to test its effectiveness in a human eye model and its safety in a whole animal model. If successful, this could replace a cycle of ineffective treatments with a single, cell-based therapy that heals the eye faster, reduces patient visits, and cuts the substantial economic burden on health systems.
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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.
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