This article is part of our special report Eye on Active Ageing.
SPECIAL REPORT / With an ageing population and blindness on the rise, German ophthalmic experts are taking strides to find innovative solutions to the sight crisis looming over Europe with pioneering implant technology.
Blindness is often caused by corneal diseases. The established treatment is a corneal transplant, but in many cases this is not possible and donor corneas are often hard to come by.
In the future, an artificial cornea – the transparent layer in front of the eye – could make up for this deficiency and save the vision of those affected.
Thousands of people have lost their eyesight due to harm to the cornea, such as trauma, damaged stem cells or diseases.
Cornea transplants are the therapy of choice for many of patients. Yet there are complications: there is a shortage of donor material and some patients cannot tolerate the implants.
In Germany – where around 7,000 patients are waiting to be treated – the Potsdam-based Fraunhofer Institute for Applied Polymer (IAP) research is attempting to improve the situation by developing an artificial cornea.
"We are in the process of developing two different types of artificial corneas. One of them can be used as an alternative to a donor cornea in cases where the patient would not tolerate a donor cornea, let alone the issue of donor material shortage," said project manager Joachim Storsberg.
New implant technologies
Clinical trials are about to start in Cologne and those involved rate the chances of success very highly.
At Heidelberg University Eye Clinic, new ways of bringing treatment to patients are being combined with new implant technologies to head of the rising problem of poor sight.
A new mobile cataract unit allows surgeons to provide cover for many more patients, increasing the number of operations by 15% within the past year.
Gerd Auffarth, deputy director of the Heidelberg clinic, believes the unit will be able to take on increasing numbers of cataract patients in the future.
Germany readies for ageing eyes
Heidelberg is developing improved implants that enable the eye pressure to remain regular, and assisting normal sight. These implanted stents can be can be injected through corneal incisions of less that 0.5 millimetres.
More than 2,000 patients are being followed in controlled studies and the device appears as safe as alternative cataract surgery.
“The ophthalmology department in Heidelberg is doing what it can to catch up and prepare itself for the already increasing number of ageing patients with age-related eye diseases,” said Auffarth.
“Germany is not particularly prepared for the onslaught of eye diseases, said Norbert Pfeiffer, director of the Mainz University Eye Clinic. “At the moment the German Ophthalmology Society is performing research to establish the magnitude of the problem. We will then address politicians and present them with the evidence. To help gather more evidence, the Department of Ophthalmology at Mainz University is conducting a very large population survey to establish the prevalence and incidence of major age- related eye diseases such as glaucoma and diabetic retinopathy.”
“These are some of the measures we are taking in Heidelberg, but this problem has to be addressed on both the national and international level, as Germany is not alone in its ageing patient demographics,” said Heidelberg University’s Dr Gerd Auffarth.
The prevalence of eye diseases is increasing – with the global incidence set to double between 1990 and 2020- World Health Organization figures show.
Blindness is a common complication of other diseases, or the result of common age-related complications.
Every five seconds someone around the world goes blind and 80% of blindness is preventable or curable. There are 285 million people worldwide who suffer serious vision impairment. Of those cases, 90% occur in the developing world.
- 2012-2013: Clinical trials results on artificial corneas to be conducted
EU official documents
Think tanks & Academia
The World Health Organization: Vision 2020: The Right to Sight
EurActiv Poland: Krótkowzroczna polityka ws. opieki okulistycznej