Scrolling Characteristics of Pre-Descemet Endothelial Keratoplasty Tissue: An Ex Vivo Study

Dua, Harminder; Termote, Karolien; Kenawy, Mohamed; Said, Dalia; Jayaswal, Rakesh; Nubile, Mario; Mastropasqua, Leonardo; Holland, Simon

Abstract

Purpose

To evaluate the scrolling propensity of pre-Descemet endothelial keratoplasty (PDEK) tissue and to compare it with each component of the PDEK tissue, namely the pre-Descemet layer (Dua's layer [PDL]) and the Descemet membrane (DM).

Design

Experimental laboratory investigation.

Methods

Fourteen human donor sclerocorneal discs in which a type 1 big bubble was obtained by stromal injection of air were studied. The wall of the type 1 big bubble was excised and its grade of scrolling noted. The components of the wall (ie, the DM and PDL) were then separated and the scrolling of each was individually graded. Statistical comparison of the grade of scrolling of each layer and correlation with age was carried out; 25-?m slices of anterior and posterior stroma obtained with the femtosecond laser from 4 control samples were used for comparison. The main outcome measure was the grade of scrolling of PDEK tissue in comparison with PDL and DM.

Results

Mean donor age was 67 years. The mean grade of the scroll formed by PDEK tissue was1.6 compared to 0.64 for PDL alone and 3.6 for DM alone. The difference was statistically significant. No correlation between donor age and degree of scrolling for any of the tissues tested was found.

Conclusion

PDEK tissue scrolls less than DM. PDL scrolls the least. This demonstrates that PDL tissue splints the DM and reduces its scrolling in PDEK. This feature has relevance to tissue preparation, handling, and unscrolling in the eye during endothelial keratoplasty.

Citation

Dua, H., Termote, K., Kenawy, M., Said, D., Jayaswal, R., Nubile, M., Mastropasqua, L., & Holland, S. (2016). Scrolling Characteristics of Pre-Descemet Endothelial Keratoplasty Tissue: An Ex Vivo Study. American Journal of Ophthalmology, 166, 84-90. https://doi.org/10.1016/j.ajo.2016.03.034

• Journal Article Type: Article
• Acceptance Date: Mar 23, 2016
• Online Publication Date: Mar 30, 2016
• Publication Date: Apr 4, 2016
• Deposit Date: May 24, 2018
• Electronic ISSN: 1879-1891
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 166
• Pages: 84-90
• DOI: https://doi.org/10.1016/j.ajo.2016.03.034
• Public URL: https://nottingham-repository.worktribe.com/output/1118100
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0002939416301386?via%3Dihub
• PMID: 27038891