Новый метод трансплантации мембраны Декемта успешно восстанавливает эпителий при хронических заболеваниях роговицы

BrightMEM allograft results in epithelialization in nonhealing corneal diseases Key takeaways: - Studies, case reports and personal experience highlight the utility of the allograft. - A company official called it another way “to treat patients with chronic, nonhealing surface diseases.” KIAWAH ISLAND, S.C. — An anterior keratoplasty technique using a decellularized Descemet’s membrane allograft yielded robust corneal epithelialization in patients with nonhealing ocular surface diseases, according to new research. BrightMEM from Brightstar Therapeutics is a corneal allograft created from donated human cornea tissue that is designed to be transplanted onto the ocular surface. A study published in Cornea looked at postoperative outcomes of Descemet’s membrane anterior keratoplasty (DMAK) using the allograft. “We wanted to look specifically at how well it supported healing, symptom improvement, visual outcomes and safety,” Joshua H. Hou, MD, of the University of Minnesota, chief scientific officer at Brightstar and lead author of the study, told Healio. “In essence, is BrightMEM a viable therapy for challenging ocular surface disease? And is it safe and effective in the hands of different surgeons? The results demonstrate that it is.” According to the study, a trephined allograft was placed on the cornea with the Descemet’s side down. The researchers assessed complete epithelialization with the allograft, mean healing time and mean change in visual acuity over a follow-up period of 60 days or more. “The BrightMEM corneal allograft comes at this problem in a novel way by changing the actual surface of the cornea to promote re-epithelialization,” Hou told Healio. “Because it is a unique solution to the problem, it is synergistic with other current therapies, which include applying lubrication, anti-inflammatory medications and medications that stimulate nerve growth as eye drops on the eye.” According to the study, complete epithelialization was achieved in 84.8% of cases with a median healing time of 28 days, “depending on the etiologic subcategories of DMAK.” In cases with subtotal limbal stem cell deficiency, the healing rate was 89.4% with a median healing time of 30 days; in cases with persistent epithelial defect, the healing rate was 78.1% with a median healing time of 34 days; and in cases with neurotrophic keratopathy, the healing rate was 79.5% with a median healing time of 30.5 days. Graft retention was 91.9% overall. Hou told Healio that most patients experienced preoperative pain improvement or resolution, with the study noting a healing rate of 97.1% in 35 patients followed for more than 6 months. Ten patients who were followed for 12 months achieved a healed surface, according to the study. “There is over a 90% chance that once that membrane is in place, your patient is going to heal within about a month and keep the membrane in place,” Brandon D. Ayres, MD, of Wills Eye Hospital, told Healio. At Kiawah Eye & Retina, Ayres highlighted the study as well as additional data from the 2025 Cornea and Eye Banking Forum presented by Hou. The data demonstrated epithelization and reduced superficial corneal vascularization at 1 month in 14 patients with limbal stem cell deficiency in aniridia. Mean visual acuity improved from logMAR 1.51 to logMAR 1.02, according to the presentation’s abstract. “When they used the Descemet’s membrane, although the peripheral stem cell changes stayed, the whorl-like central epitheliopathy was reduced in the majority of these patients,” Ayres said during the presentation. “Overall, small numbers in this study, but it does look like there is some supportive evidence that it can be beneficial.” In his own practice, Ayres reported having difficulty in some cases with making sure the epithelium grows over the membrane instead of beneath it despite the straightforward procedure working “very nicely” in other patients. “Somehow putting Descemet’s on the front of the cornea seems to work pretty nicely in some cases,” he said. These positive outcomes were further reinforced by a case report in Cornea of two patients who underwent DMAK using BrightMEM as a stand-alone procedure without epithelial stem cell transplantation. The first patient, a 66-year-old man with ocular cicatricial pemphigoid-like keratoconjunctivitis, bilateral stage 3 total limbal stem cell deficiency and visually significant cataracts, underwent the procedure in combination with phacoemulsification and IOL implantation. After supplemental amniotic membrane transplantation in the left eye 3 weeks after the procedure, he experienced complete epithelialization in both eyes within 8 weeks, according to the study. The second patient was a 70-year-old man with postsurgical stage 2 partial limbal stem cell deficiency following tube shunt glaucoma surgery. He underwent DMAK combined with autologous limbal transplantation in the left eye, using limbal tissue donor from the blind right eye. This patient achieved complete epithelialization and a stable ocular surface by about day 10 after surgery, which was maintained through follow-up. “It provides another tool in the toolbox for ophthalmologists to treat patients with chronic, nonhealing surface diseases that need durable epithelialization, symptom relief and preservation of vision,” Hou told Healio. For more information: Brandon D. Ayres, MD, is an ophthalmologist at Wills Eye Hospital, Philadelphia. Joshua H. Hou, MD, an ophthalmologist at University of Minnesota and chief scientific officer at Brightstar Therapeutics, can be reached at [email protected].