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Preventing Retinal Scarring Caused by Failed Retinal Detachment Repair Surgery Using a Novel Synthetic Polymer

Researchers in Singapore have developed a novel synthetic polymer, in the form of a thermogel that reduces the incidence of vision loss after a failed retinal detachment surgery attempt.

A visual representation of how the developed thermogel prevents repeat occurrences of retinal detachment during the recovery process of retinal detachment surgery, for improved surgical outcomes. Photo Credit: Kim Chi Tran, A*STAR’s Institute of Molecular and Cell Biology (IMCB).

A team of Singaporean scientists from the A*STAR’s Institute of Molecular and Cell Biology (IMCB) and Institute of Materials Research and Engineering (IMRE), the National University of Singapore (NUS), and the Singapore Eye Research Institute (SERI) has developed a biocompatible thermogel (synthetic polymer) that reduces the instance of retinal scarring originating from unsuccessful surgery to address retinal detachment.

Proliferative vitreoretinopathy (PVR) occurs when scar tissue prevents the retina from healing and returning to its original position. This condition is the reason behind more than 75 per cent of unsuccessful retinal reattachment surgeries and has the potential to result in severe consequences like partial vision loss, or even blindness if left unaddressed.

Unfortunately, there are currently very few methods to resolve this condition, and they mostly involve the surgical removal of scar tissue. To address this issue, the team of researchers sought to explore the use of synthetic polymers to regulate cellular behaviour to avoid unwanted outcomes like the accumulation of scar tissue.

The team showed that their thermogel creation could eliminate the occurrence of retinal scarring through a pre-clinical model. They observed that the thermogel regulated cellular behaviours such as migration and proliferation in retinal cells. Furthermore, after profiling the cells’ gene expression by transcriptomic analysis, it was discovered that the thermogel triggered a nuclear factor protein erythroid 2-related factor 2 (NRF2) that activates biomechanisms that prevent scarring.

According to Dr. Su Xinyi, Senior Principal Investigator and Division Director at A*STAR’s IMCB, and Assistant Professor in the Department of Ophthalmology at NUS Yong Loo Lin School of Medicine, the study shows how the functions of biopolymers are becoming increasingly varied, and they are no longer restricted to being inert drug carriers.

The team hopes that their novel biodegradable polymers designed to resemble and replace vitreous in the eye, with its high biocompatibility, may be used in other fields of medicine. For example, it may find future uses in fields like orthopaedics, to minimise intra-articular joint scarring.

The thermogel is currently being scaled up by Vitreogel Innovations Inc, a spin-off of A*STAR, which focuses on the innovation of biocompatible polymers as treatments in the field of ophthalmology. It is an ISO 13485 (Medical Device Quality Systems)-certified firm that is in the process of manufacturing the product for human clinical trials.

The researchers will carry on their efforts to ensure that their developed product is safe and improves the outcomes of retinal detachment surgery, through further testing with more pre-clinical disease models. The team hopes to design more cutting-edge, precisely designed polymers that regulate other types of cell behaviours to achieve specific goals and find other areas of medicine in which they might use their thermogel for other therapeutics. [APBN]

Source: Parikh et al. (2022). A bio-functional polymer that prevents retinal scarring through modulation of NRF2 signalling pathway. ;Nature Communications, ;13(1), 1-16.