TWELVE million people are blind because the corneas in front of their eyeballs are damaged by ageing, infections, injuries, genetic disorders and other diseases.

The Singapore Eye Research Institute (Seri) is in the forefront of efforts to improve corneal transplants to restore the eyesight of victims of corneal blindness living mainly in Asia and Africa.

Innovative transplants were invented in the last 10 years by a Seri team which won the prestigious President’s Science Award. Professor Donald Tan, the chairman of Seri, is the leader of the team.

His team-mates are Seri’s senior scientific director, professor Roger Beuerman, and its deputy director, Associate Professor Aung Tin.

The trio were the first in the world to grow human stem cells in a laboratory to produce conjunctival tissue. The tissue is grown from a patient’s stem cells in the normal eye. It is transplanted to the other eye to restore vision.

“We don’t use animal cells or serum to grow stem cells because we want to eliminate the risk of disease transmission,” Prof Tan says.

The team introduced innovations in keyhole corneal transplantation surgery to replace the damaged layer of a cornea through a four millimeter incision.

A surgical device was invented and patented by Prof Tan for the procedure.

The loss of healthy cells is reduced because surgeons do not use the conventional manual technique, Prof Tan says.

“Without the device, you lose 30 to 40 per cent of the healthy cells. The easy-to-use device cuts the loss to 19 per cent. This is a huge reduction.”

The Seri team are the pioneers of a complex two-stage operation using the tooth of a completely blind patient to make and transplant an artificial cornea.

The Singapore National Eye Centre (SNEC) is one of the few places performing the operation. All SNEC “tooth-in-eye” patients regained their maximal potential vision, Prof Tan says. “Sixty per cent of them now have perfect vision.”

Medical research by the team also advanced scientific knowledge about the cause of several corneal diseases.

It identified the gene that blind babies born with a severe form of congenital corneal blindness.

The team also discovered mutations of the same gene in adults with the mist common form of premature ageing of the corneas.

This discovery provides research opportunities to develop gene therapy for premature degeneration of corneas among older folk in Singapore’s rapidly ageing population.

Epidemiological population research by the Seri team prevented a huge global outbreak of blinding fungal corneal infections in 2006.

It was the first to prove that contaminated ReNu contact lens cleaning solution in 2006, saved the eyesight of thousands of users of the product.

Using a laser to do a corneal transplant is one of the cornea projects the Seri team will continue to develop in a new programme.

It is in charge of the $25 million five-year programme funded by a grant from the National Research Foundation.

The programme will develop better anti-scarring and wound-healing treatments for corneal diseases and glaucoma.

Its projects will be based on the Seri team’s approach to ensure that medical research in a laboratory benefits people.

This approach and collaborations with Seri colleagues and health-care professionals in SNEC and other groups continue to be the key to success for the team.

Prof Tan says: “My team accepts the award on behalf of all the clinicians and scientists working together with us.

“We are proud that the work we did made a major difference to many blind patients in Singapore and other countries.

“We are now doing corneal transplants with better results.

“Stem cell transplants and artificial cornea surgeries help patients we could not help in the past.

“We stopped thousands from being blinded by corneal fungal infections. These are the most rewarding aspects of our work.”