Corneal Transplantation

Corneal transplantation is by far the most common tissue transplant with over 100,000 performed worldwide each year. It is indicated for sight-threatening loss of clarity or distortion of the cornea, which can be caused by a wide range of conditions including dystrophic and degenerative processes, infections and inflammatory diseases, traumatic or chemical injuries and the complications of eye surgery including loss of a prior corneal graft.

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  • What are the Most Important Challenges and Unanswered Questions about Corneal Transplantation?
  • How Will VISICORT Help to Answer These Questions?
  • The VISICORT Project Patient Cohorts

From 2014 to 2019, the VISICORT project enrolled over 1700 patients with corneal transplants or other eye conditions into our clinical studies. These patients have agreed to contribute their clinical information and biological samples (blood, tears, peripheral blood immune cells, donor cornea issue, recipient cornea tissue, aqueous humour) at five leading European ophthalmology centres: Aarhus University Hospital, Denmark, Bristol Eye Hospital, UK, Charité Universitätsmedizin Berlin, Germany, Nantes University Hospital, France, Royal Victoria Eye and Ear Hospital, Dublin, Ireland. Click here to read more.

In addition, groups of patients with cornea disease who have not received a corneal transplant and healthy volunteers without any corneal disease have also agreed to provide biological samples and clinical information for comparison with those of corneal transplant patients.

A web-based clinical database called the VISICORT Information Management System (VIMS) has been developed which classifies high risk and low-risk patient groups. This database brings together the clinical details of all patient groups and will allow for the results of biological specimen analysis to be linked to patients’ clinical characteristics at the time of transplantation or at the time a complication such as rejection occurs.

The VISICORT Biological Profiling Projects

In the past decade, the field of solid organ transplantation has seen the emergence of large-scale profiling projects applying systems biology approaches to animal models and bio-specimens from cohorts of human recipients. Such studies have generated important insights into the immune mechanisms underlying acute and chronic transplant complications.

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Breakdown of Transplant Diagnosis

An important emphasis for the clinical study and for the immunological profiling/biomarker identification projects will be the comparison of Low- and High-Risk CT. High-Risk CT (those at high risk for acute rejection) will be categorised based on the recognised clinical risk factors of re-transplantation, inflammatory corneal disease at the time of transplantation, the occurrence of an early surgical complication, or stromal vascularisation.

  • Low-risk status is defined as patients with keratoconus, iatrogenic ectasia, Fuchs endothelial dystrophy, stromal dystrophy, and no risk factors (inflammation, glaucoma, ocular surface disease, previous graft in contralateral eyes, vessel ingrowth)
  • High-risk status is defined as patients with previous corneal herpes simplex, secondary bullous keratopathy, re-grafting in the same eye, actual or threatening perforation.

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