Ongoing Projects

Advanced DMEK – How to further improve DMEK outcomes?

With the increasing number of DMEK surgeries performed in eyes with advanced corneal disease, we focus on gaining more insight in the surgeries performed in these complex eyes as well as the clinical outcome and the required medical aftercare. The findings are translated directly back into clinical practice to further improve outcomes after DMEK.

Personalized DMEK – How to perform tailor-made DMEK surgeries?

DMEK is usually performed with an “one size fits it all” approach that does not consider patient-specific characteristics of the underlying endothelial disease. For Fuchs endothelial corneal dystrophy patients, we evaluate the effect of precisely determining the extent of guttae progression to adapt the graft size for preserving as many healthy peripheral endothelial cells as possible.

Bowman Layer Transplantation – How to treat advanced progressive keratoconus less invasively?

Bowman layer (BL) transplantation is a new technique to stop the progression of advanced keratoconus in patients not eligible for UV-crosslinking. By placing the graft as an onlay, the procedure can be performed minimally invasive resulting in lower intra- and postoperative risks compared with more invasive keratoplasty techniques such as PK or DALK.

Optimizing Donor Tissue Use – How to provide the best possible grafts to surgeons?

Available donor tissue should be used as efficiently as possible, and the prepared grafts should be of the highest quality to ensure optimal postoperative outcomes. To achieve these goals, we focus on developing new graft preparation techniques and on improving graft evaluation and graft storage conditions.

Cell Replacement Therapies – How to advance the treatment options for endothelial diseases?

Worldwide shortage of corneal donor tissue remains a major challenge for corneal transplantation. Culturing of endothelial cells has the potential to mitigate this shortage and to broaden the treatment options for corneal endothelial diseases. Our research focuses on developing a cell-based injection therapy for patients in need of an endothelial cell replacement.

Ultrastructural Tissue Analysis – How to reveal more information on graft-host interaction?

Ultrastructural tissue analysis performed in our in-house pathology lab, provides us with additional insight into graft-host interactions after corneal transplantation to further reduce postoperative complications such as DMEK graft detachment. In addition, it enables us to validate new graft preparation methods developed by Amnitrans EyeBank Rotterdam.

E-Device – How to perform remote examinations?

We are currently investigating a portable, all-in-one ophthalmic diagnostic device that allows patients to collect their own ophthalmic data. The device enables general remote ophthalmic self-examinations i.e., biomicroscopy, fundoscopy, visual acuity measurements and intraocular pressure assessments can be performed without the patient having to visit the clinic.

Ophthalmic Staining Solutions – How to make the invisible visible in the eye?

To enhance the visualization of intraocular structure, NIIOS R&D’s focus is to improve staining efficiency and further reduce the cytotoxic effects of ophthalmic staining solutions. Vital-dye staining solutions which were developed by NIIOS R&D and are now routinely used throughout the world, include VisionBlue®, MembraneBlue Dual®, and ILM Blue®.

Developing Surgical Instruments – How to facilitate innovative surgical procedures?

Our innovative surgical procedures are becoming less and less invasive and therefore require state-of-the-art instruments. Using our first-hand surgical insight, we have designed an innovative range of surgical instruments and remain dedicated to further improve outcomes of corneal transplantation by developing safer custom-made instruments.