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Cataracts: could a new approach to surgery improve children’s vision?

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What did the project achieve?

“We have made exciting discoveries about how lens growth is driven by electrical signals in the eye – and that by harnessing these signals it should be possible to promote lens regeneration,” says Professor Colin McCaig of the University of Aberdeen.

“If complete lens regeneration can be achieved, it will transform cataract treatment, meaning children will be able to have a fully functional lens throughout life,” he adds.

Although usually associated with older people, each year over 200 babies in the UK are born with cataracts1 – and worldwide it is a major cause of childhood blindness. Current treatment involves replacing the diseased lens in the eye with an artificial implant. But this isn’t always successful and, even if it is, these lenses can’t focus as well as natural ones.

Professor McCaig and his team used a variety of experiments to uncover and explain the pivotal importance of electrical signals in lens development and in cataract formation. They are now looking for ways to apply these important discoveries to develop new treatments to prevent or reverse cataract formation.

“Excitingly, my colleague Dr Lin Cao discovered that a compound originally derived from ocean plants can boost the electrical signals, making them more effective,” says Professor McCaig.

Dr Cao then showed that this compound can also stimulate the growth and development of lenses grown in dishes and reduced the formation of cataracts in a living system.

“We now plan to develop this compound into a medicine to prevent and treat cataracts,” says Professor McCaig.

References

  1. RNIB. Congenital cataracts. https://www.rnib.org.uk/eye-health-eye-conditions-z-eye-conditions/congenital-cataracts [Website accessed 17 Sep 2018]

This research was completed on

Around 200 babies are born with cataracts each year in the UK.1 They can develop blurred or misty vision, or even go blind. Indeed estimates suggest up to 210,000 children worldwide have lost their sight to cataracts.2-4 Surgery can restore children’s vision if done soon enough, but its effects aren’t perfect. Professor Colin McCaig, of the University of Aberdeen, is investigating whether a revolutionary new approach to surgery might give children better eyesight than is currently possible – a benefit that would have far-reaching implications for children and their families.

How are children’s lives affected now?

Globally, nearly 18 million people are blind because of cataracts – the world’s single most important cause of blindness.3 Most are older, but babies and children get cataracts too.

Cataracts grow in the eye’s lens, which focuses light to create the images we see. Lenses are normally clear, but cataracts make them hazy.

“Surgery for cataracts is – without doubt – beneficial,” says Professor McCaig. “However, children’s vision often remains less than perfect even if surgery is successful.”

During surgery, cataracts are removed and the eye’s lens is replaced by inserting an artificial one into the eye, or by wearing contact lenses or glasses.

“Unfortunately, artificial lenses cannot focus as well as natural ones, meaning children can still face a life of restricted vision even if they undergo surgery,” says Professor McCaig. “What’s more, children are particularly susceptible to a complication after surgery called posterior capsular opacification or PCO. This is like a secondary cataract. It further impairs children’s vision, requiring yet more interventions.”

How could this research help?

“We are studying a possible new approach to cataract surgery that we believe could revolutionise treatment and transform children’s lives for the better,” says Professor McCaig.

The team’s laboratory investigations will reveal whether their new approach has the potential to offer two important benefits: whether it might help to prevent children from getting secondary cataracts and whether it might encourage the eye’s lens to grow back naturally after surgery – something that was long thought impossible.

“If complete regeneration of the eye’s lens could be achieved, this would be of major benefit to children,” says Professor McCaig. “It’s too early to be sure as our work is still in the laboratory stages, but we think the eye would be able to adjust its focus well – much better than with artificial lenses – greatly improving children’s eyesight and profoundly affecting quality of life. Many older people with cataracts could eventually benefit too.”

References

1. RNIB. Congenital cataracts. http://www.rnib.org.uk/eyehealth/eyeconditions/conditionsac/Pages/congen... Website accessed 15 January 2014.

2. Wilson E et al. Childhood blindness and pediatric cataract. Cataract and Refractive Surgery Today, October 2005, p52-4. http://www.crstoday.com/PDF%20Articles/1005/CRST1005_SF_Wilson30.pdf Website accessed 15 January 2014.

3. World Health Organization 2007. Vision 2020. The right to sight. Global initiative for the elimination of preventable blindness. Action plan 2006-2011. http://www.who.int/blindness/Vision2020_report.pdf Website accessed 15 January 2014.

4. World Health Organization. Preventing blindness in children. Report of a WHO/IABP scientific meeting. 2000. http://www.who.int/ncd/vision2020_actionplan/documents/WHO_PBL_00.77.pdf Website accessed 28 January 2014.

 

Project LeaderProfessor Colin D McCaig BSc PhD
Project TeamProfessor J Martin Collinson MA PhDProfessor John V Forrester FRSE FMedSciProfessor Noemi Lois MD, PhD, FRCS(Ed), FRCOphth
Project LocationSchool of Medical Sciences, Institute of Medical Sciences, University of Aberdeen
Project Location OtherOphthalmology, Institute of Medical Sciences, University of AberdeenClinical Ophthalmology, Centre of Vision and Vascular Science, Queens University, Belfast
Project duration3 years
Date awarded15 November 2013
Project start date1 April 2014
Project end date30 September 2017
Grant amount£191,577
Grant codeGN2199

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