Study will use 3D bio-artificial tissue model to improve understanding of wound healing after glaucoma surgery

James Armstrong, an MD/PhD student at Western University’s Schulich School of Medicine & Dentistry conducting research at Lawson Health Research Institute, is creating a 3D bio-artificial tissue model to study wound healing following glaucoma surgery.

There are currently no curative treatments for glaucoma, the leading cause of irreversible blindness world-wide. The only therapy that can delay the progression of the disease is the reduction of intra-ocular pressure, which can be accomplished by taking drugs or undergoing surgery. Surgery is usually a last resort if pharmacological treatment is unsuccessful as many of these surgeries fail due to excessive healing of the surgical wound. A dense, scar-like tissue can develop at the surgical site, which blocks the pressure-lowering effect and leads to surgical failure, revision and even blindness.

Armstrong will identify risk factors for fibrotic glaucoma surgery failure through reviews of electronic patient records and literature. Using the constructed model of the ocular tissue involved in glaucoma surgery, he will simulate the surgical wound to study the physiology of how the tissue heals and test potential drugs designed to modulate the wound healing process.

The project has been awarded a Lawson Internal Research Fund (IRF) Studentship, and is supervised by Lawson scientist and St. Joseph’s Health Care London physician Dr. Cindy Hutnik.

“Right now there is a shift happening towards earlier surgical interventions for glaucoma so an understanding of the wound healing response is critical to ensure safe and successful outcomes for patients,” Armstrong says. “Future work in this area could include developing a diagnostic test to inform physicians of a patients’ likelihood of excessive healing before the patient even sets foot in the operating room. This will allow surgeons to ‘customize’ how they pre-treat each individual patient with wound healing modulating drugs.”

Although this study is focused on wound healing within the eye, the same processes are at work in many other diseases. Understanding and having the ability to manipulate wound healing mechanisms could have widespread applicability, not only for glaucoma, but also for other diseases such as atherosclerosis, interstitial pulmonary fibrosis, hepatic fibrosis, systemic sclerosis or muscular dystrophy, as well as heart, kidney or liver failure.

“The IRF has given me the opportunity to pursue research in an area where any progress could impact a significant portion of the population,” Armstrong says. “It’s a great way for researchers who are early in their career to get a foot in the door. It allows them to collect the amount of data necessary to receive funding from larger granting agencies.”

The IRF is designed to provide Lawson scientists and students the opportunity to obtain start-up funds for new projects with the potential to obtain larger funding, be published in a high-impact journal, or provide a clinical benefit to patients. Funding is provided by the clinical departments of London Health Sciences Centre and St. Joseph’s Health Care London, as well as the hospital foundations (London Health Sciences Foundation and St. Joseph's Health Care Foundation).