The Evolution of Endothelial Therapeutics

Authors

  • Greg Moloney, MBBS (Hons), BSc(Med), MMed, FRANZCO, FRCSC University of British Columbia, Vancouver, BC, Sydney Eye Hospital, Sydney, AUS, Sydney University, Sydney, AUS
  • Antoine Sylvestre-Bouchard, MD, MSc. Section of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB
  • Mary Holdsworth, MD, BSc, MScPH Section of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB

DOI:

https://doi.org/10.58931/cect.2025.4155

Abstract

Corneal endothelial diseases comprise a spectrum of conditions that critically affect the health and transparency of the cornea, posing unique challenges for ophthalmologists. The most prevalent among these is Fuchs’ endothelial corneal dystrophy (FECD), which accounts for approximately 39% of all corneal transplants globally. Bullous keratopathy (BK) can affect the entire cornea, leading to painful blisters that may become infected. Other rarer pathologies, such as iridocorneal endothelial syndrome, posterior polymorphous corneal dystrophy, and congenital hereditary endothelial dystrophy, present unique diagnostic and therapeutic challenges. Additionally, graft failure remains a notable indication for treatment. High-risk cases experience failure rates exceeding 35% within 3 years, with endothelial rejection accounting for half of the cases. Corneal transplants have been considered the gold standard for decades, with advancements in surgical techniques leading to shorter operating times, faster visual recovery, and improved outcomes. However, the growing global shortage of transplant-grade donor tissue further complicates treatment, underscoring the urgent need for innovative approaches such as genetic and cell-based therapies.

Author Biographies

Greg Moloney, MBBS (Hons), BSc(Med), MMed, FRANZCO, FRCSC, University of British Columbia, Vancouver, BC, Sydney Eye Hospital, Sydney, AUS, Sydney University, Sydney, AUS

Dr. Moloney is an Australian ophthalmologist trained at Sydney Eye Hospital, with fellowship training in Cornea and Oculoplastics at the University of British Columbia. He now lives and works in Vancouver as Clinical Associate Professor at UBC. His main areas of research interest are Fuchs Dystrophy, therapeutic laser refractive surgery and anterior segment reconstruction including keratoprosthesis.

Antoine Sylvestre-Bouchard, MD, MSc., Section of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB

Dr. Antoine Sylvestre-Bouchard serves as the chief ophthalmology resident at the University of Calgary, a role through which he was honored with the Calgary PGME Resident Leader Award and the PARA Resident Physician Leadership Award. He holds an MD-MSc from the University de Montréal, where he conducted research on the biocompatibility of a novel corneal biosynthetic implant designed to replace allografts in complex inflammatory diseases. Previously, he held the position of Research Director, and he currently serves as the Communications Director for the Council of Canadian Ophthalmology Residents. On top of medical education, advanced anterior segment surgery and visual rehabilitation, he is highly invested in the application of AI and VR in vision health.

Mary Holdsworth, MD, BSc, MScPH, Section of Ophthalmology, Department of Surgery, University of Calgary, Calgary, AB

Dr. Mary Holdsworth is currently in her second year of residency at the University of Calgary. She holds an MSc in Public Health and Epidemiology, where she focused on outcomes research and social epidemiology. Her interests also include mentorship and global ophthalmology.

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Published

2025-06-17

How to Cite

1.
Moloney G, Sylvestre-Bouchard A, Holdsworth M. The Evolution of Endothelial Therapeutics. Can Eye Care Today [Internet]. 2025 Jun. 17 [cited 2025 Jun. 28];4(1):25–3`1. Available from: https://canadianeyecaretoday.com/article/view/4-1-Moloney_et_al

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Volume 4, Issue 1, Spring 2025

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