AAO 2023: Advancements in endothelial cell injection therapy


Edward J. Holland, MD, and Professor Shigeru Kinoshita, MD, discuss how a single donor cornea could potentially help over a thousand patients.

Edward J. Holland, MD, and Professor Shigeru Kinoshita, MD, spoke with Ophthalmology Times about advancements in endothelial cell injection therapy at this year's American Academy of Ophthalmology meeting.

Video Transcript

Editor's note - This transcript has been edited for clarity.

Edward J. Holland, MD: Hi, I'm Edward Holland. We're here at the American Academy of Ophthalmology annual meeting in San Francisco. I'm here with Professor Shigeru Kinoshita. We want to talk about one of the most incredible innovations in corneal surgery. And that's your incredible work on endothelial cell injection therapy. Can you tell us a little bit about that?

Professor Shigeru Kinoshita, MD: About 20 years ago, we started this kind of project. And then actually for the corneal endothelial transplantation you may do a DSEK or a DMEK procedure. But rather than that, I think just the inject the cells into the anterior chamber and face down position for 3 hours that could automatically, say, self-organize these cells onto the posterior surface of the cornea. So that's the kind of procedure.

Dr Holland: So this technology is really going to change the way we do corneal transplantation. So no longer where patients who've had endothelial keratoplasty have to lay on their back for one or two days. And we do have a significant graft attachment problem. That's still a big issue. Plus, we lose a lot of cells with the standard therapy. With your technique in growing millions of cells, we're going to have a better experience for the patient; we're going to really reduce the complication rates significantly; and also we are going to have a higher cell count with better outcomes.

So for each individual patient, that's remarkable. But how about what it will mean to eye banking and really dealing with world corneal blindness?

Dr Kinoshita: In the US, you may have enough number of the donor corneas. But when we are thinking of the worldwide basis, there are quite a shortage of the donor corneas. At least we could create the culture cells for like a thousand patients, starting from just one donor cornea, and also we started the donor cornea using a rather young donor cornea. So that means the endothelial cell itself is also a very young so we could rejuvenate cornea endothelial so not like a replacement. So that is our idea.

Dr Holland: So it's really incredible. One donor cornea could potentially help over a thousand patients. And really, we can potentially now with this technology start to address world corneal blindness. There's over 6 million people in the world bilaterally blind. And so Aurion Biotech has got your technology and has started clinical trials. Obviously you've got approval in Japan. We did the first trials outside Japan in El Salvador, a proof of concept. But just last week, Aurion Biotech's clinical trial Phase 1/Phase 2 had first in-human patients, and it's a very, very exciting time. I think this is going to be one of the most incredible breakthroughs in corneal transplantation. And I want to thank you.

Dr Kinoshita: Yeah, thank you very much.

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