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Sydney ophthalmologist develops synthetic gel for corneal injuries

Australian researchers are part of an international team pioneering a synthetic gel treatment that could repair corneas damaged by injury or infection, removing the need for transplant surgery.

Associate Professor Chameen Samarawickrama, from the University of Sydney’s Faculty of Medicine and Health and The Westmead Institute for Medical Research, has helped develop and perform preclinical testing of LiQD Cornea, an adhesive liquid that is designed to mend damaged corneas.

The study he co-authored – recently published Science Advances – states that transplantation with donor corneas has been the mainstay for treating corneal blindness, but a global shortage has highlighted the need for other treatment options.

At present, corneal perforation from infection or inflammation is sealed with cyanoacrylate glue. However, the resulting cytotoxicity means that without follow-up corneal transplantation, sight could be lost.

Appearance of the glue on application in a human eye donated for research purposes. A small section is stained blue for visualisation, while another section (far right) shows the glue without stain.

LiQD Cornea is an alternative to conventional corneal transplantation and sealants. It is a cell-free, liquid hydrogel matrix for corneal regeneration. It is said to comprise short collagen-like peptides conjugated with polyethylene glycol and mixed with fibrinogen to promote adhesion within tissue defects.

The process of gelation occurs spontaneously at body temperature within five minutes, potentially allowing for clinical application in outpatient clinics, instead of operating theatres, and therefore minimising healthcare costs.

About 4,300 Australian’s sustain corneal injuries each year, but the figures are much higher in developing countries where agricultural accidents are a common cause.

Samarawickrama has collaborated with colleagues at the University of Montreal in Canada and Linkoping University in Sweden on the conception and manufacturing of LiQD Cornea. He and post-doctoral researcher Mr Damien Hunter carried out a trial with rabbits, one of the two pre-clinical trials detailed in the paper, finding LiQD Cornea worked effectively on smaller injuries.

“It acts very much like a dental filling,” Samarawickrama said.

“It comes out as a liquid and sets in a gel form, stays on the eye comfortably, doesn’t scar and remains see-through or translucent, countering many of the limitations of the tissue glue currently used. Our early studies also suggest it allows the eye to continue to regenerate.”

Due to the synthetic nature of the material, risks associated with immune rejection and disease transmission are also reduced in comparison to natural products.

While further pre-clinical studies are needed to ensure safety and efficacy before progressing to human trials, Samarawickrama said the results are encouraging noting that the cornea is avascular in all mammals, increasing the likelihood of similar outcomes in humans.

“If successful, LiQD Cornea could be applied outside the operating room setting, meaning there is immense potential to reduce healthcare costs and increase patient access,” he said.