Retinal specialist Mandeep Singh, M.D., Ph.D., fell in love with surgery as a resident. “I think retinal surgery is a most beautiful thing,” he says. “The delicacy of it, the precision of it attracted me.” As a clinician-scientist, Singh sees patients and engages in research—both of which involve complex surgical skills. His research focuses on solving the problem of stem cell delivery to the retina.

Retinal stem cells hold the promise of protecting—and restoring—vision in people with currently untreatable diseases, but first they must be transplanted successfully into the eye.

“Retinal stem cell surgery is a modern concept,” says Singh. “The surgical protocols and instrumentation required haven’t been designed and optimized anywhere in the world to our knowledge.”

Today, surgeons can deliver medication and gene therapy to the retina, but these are delivered in liquid form. “For us to deliver fluid into the retina, the instruments can be really fine,” says Singh. “But if you try to deliver cells through very fine instruments, the cells are at risk of damage and rupture.”

The instruments for retinal stem cell delivery need to be different. “They need to be able to protect the cells on the way in, ensure that there’s no damage to the stem cells that are being transplanted and also avoid bleeding and tissue injury and other complications during the surgical procedure,” says Singh.

Because Singh trained with experts in retinal stem cell and gene therapy, he noticed an opportunity upon joining the Wilmer faculty several years ago. “When I arrived, I was aware that this is a field that needed more development,” he says. “I was excited that it was easy to connect with top-class bioengineers, physicists and materials scientists. You need to bring this sort of a team together to accomplish the very complex goal of designing a new biocompatible device for stem cell delivery.” His current research project involves people from Johns Hopkins engineering and also the Applied Physics Laboratory.

“We started by stating the problem,” says Singh. “We need to deliver these cells into the correct retinal location and we need to protect them on the way in,” says Singh. They began with drawings and sketches of a prospective device.

The overall project extends beyond creating the optimal instrument, though. “Part of it is designing the right tools and devices that can gain access into the eye safely. The other part is designing the sequence of steps that need to be done during this complex surgical procedure from start to finish,” says Singh. The latter is called a surgical protocol.

“We have developed a refined prototype and protocol and we’re ready to begin testing with stem cells in the near future,” says Singh. “We’re confident that when we deliver the cells, they will be viable and placed accurately and safely into the retina.”

His confidence stems from the results of the work and from the caliber of his colleagues. “A highly scientific environment like Wilmer, with deep connections within the entire Johns Hopkins community, provides the synergy you need between surgery and science to accomplish this sort of a goal,” says Singh.