Meet the team leading the fight against global corneal blindness

Corneal blindness is a condition that affects the cornea, the clear window at the front of the eye. It is the third most common cause of blindness in the world.

An estimated ten million people suffering from bilateral blindness (affecting both eyes) and 23 million are unilaterally blind (affecting one eye). 

BIENCO - a world first consortium of clinical, scientific and governance experts from the University of Sydney, University of Wollongong, University of Melbourne, Queensland University of Technology, the Centre for Eye Research Australia, and the NSW Organ & Tissue Donation Service – is creating corneal replacement tissue by incorporating cells and tissue generously donated by deceased donors.

The program aims to improve the quality of life of patients nationally and globally, and reduce the social and economic burden associated with blindness.

BIENCO program lead Professor Gerard Sutton said corneal blindness has a profound impact on people’s lives and presents a significant cost to the health system.

“Blindness not only severely impacts a person’s ability to function in their life, it is also associated with many other secondary problems such as depression, falls, hip fractures, isolation. For many people, fear of blindness is worse than fear of death,” said Professor Sutton, corneal specialist at the University of Sydney's Save Sight Institute and co-medical director of the NSW Tissue Bank.

“Corneal injury is also a common reason for presentation emergency departments in Australia, with an estimated 55,000 presentations a year,” said Professor Sutton, “Corneal infections are another common reason for hospital admission and conditions such as Keratoconus, where the cornea bulges outwards, and a disorder of the inside of the cornea called Fuchs Dystrophy are both problems that require corneal transplantation.”

Corneal transplantation currently relies on human donor corneal tissue; however, an acute global shortage of tissue means it is only available for approximately one in 70 patients. Fifty three percent of the world’s population are unable to access tissue at all.

By developing bioengineered eye tissue, BIENCO hopes to minimise dependency on tissue from deceased donors and provide multiple, customised therapies for corneal disease. There will be an emphasis on transportable therapies with extended shelf-life for use in remote communities, particularly for Aboriginal and Torres Strait Islander Australians.

“Apart from developing treatments that prevent blindness, this program aims to develop a bioengineered cornea that can reduce costs, reduce waiting times and free up healthcare resources. It also has the potential to produce a cornea that is more resistant to rejection and lasts longer,” said Professor Sutton. 

BIENCO is generating prototypes of bioengineered tissue using combinations of novel technologies such as cell culturing and 3D bio-printing, laying a solid foundation to move to the development stage of the project. The biotechnology developed by the consortium will go beyond the creation of bioengineered corneal tissue to solve wider biomedical problems and enhance Australia’s reputation in bioengineering.

“Our program will not only facilitate a bioengineered cornea but produce basic high quality Good Manufacturing Process grade substrates, like collagen that can be used to bioengineer other organs, such as the heart,” said Professor Sutton. “It will also contribute to the expertise and knowledge in Australia, helping us to become world leaders in the field of bioengineering.”

BIENCO is funded through the Australian Government’s Medical Research Future Fund 2021 (MRFF) Frontier Health and Medical Research Initiative, which aims to transform health and medical research and innovation to improve lives, build the economy and contribute to health system sustainability. 

It’s an initiative that Professor Sutton is optimistic about.

“The Australian governments, both state and federal, are investing heavily in technology, including biotech,” he said.

“Our research group at the University of Sydney, University of Wollongong and the Organ and Tissue Donation Service has already won another grant of over one million dollars from the NSW government and a number of awards in this area, including the Inaugural Big Idea Award from Sydney Research. BIENCO is a great example of synergistic collaboration with a little serendipity thrown in for good measure.”