September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
A Surgical Cryoprobe for Targeted Transcorneal Freezing to Treat Corneal Endothelial Dysfunction
Author Affiliations & Notes
  • Alina Akhbanbetova
    Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, United Kingdom
  • Shinichiro Nakano
    Biomedical Engineering, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto, Japan
  • Stacy L Littlechild
    Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, United Kingdom
  • Robert D Young
    Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, United Kingdom
  • Madara Zvirgzdina
    Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, United Kingdom
  • Nigel J Fullwood
    Biomedical and Life Sciences, Lancaster University, Lancaster, Lancashire, United Kingdom
  • Shigeru Kinoshita
    Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  • Naoki Okumura
    Biomedical Engineering, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto, Japan
  • Noriko Koizumi
    Biomedical Engineering, Doshisha University, 1-3 Miyakodami-Tatara, Kyoto, Japan
  • Andrew J Quantock
    Optometry and Vision Sciences, Cardiff University, Cardiff, South Glamorgan, United Kingdom
  • Footnotes
    Commercial Relationships   Alina Akhbanbetova, None; Shinichiro Nakano, None; Stacy Littlechild, None; Robert Young, None; Madara Zvirgzdina, None; Nigel Fullwood, None; Shigeru Kinoshita, None; Naoki Okumura, None; Noriko Koizumi, None; Andrew Quantock, None
  • Footnotes
    Support  Ser Cymru The Life Sciences Research Network Wales UK: Research Studenship
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1248. doi:
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      Alina Akhbanbetova, Shinichiro Nakano, Stacy L Littlechild, Robert D Young, Madara Zvirgzdina, Nigel J Fullwood, Shigeru Kinoshita, Naoki Okumura, Noriko Koizumi, Andrew J Quantock; A Surgical Cryoprobe for Targeted Transcorneal Freezing to Treat Corneal Endothelial Dysfunction. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1248.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : To examine the effects on corneal tissue of localized freezing induced by a new surgical cryoprobe. The machine was designed to remove endothelial cells from the posterior surface of the cornea in a reproducible and targeted manner to aid the treatment of corneal endothelial dysfunction.

Methods : A freezing console was designed and manufactured based on the use of nitrous oxide as a cryogen. The console was connected to one of four different cryoprobes, each with a different freezing tip (1.8 mm-diameter, flat profile; 2.4 mm-diameter, flat profile; 2.4 mm-diameter concave profile; 3.4 mm-diameter, concave profile) at which temperatures below -50°C were achieved. In vitro studies were conducted on 426 porcine corneas, followed by a small number of in vivo investigations on rabbit corneas. After treatment the epithelial basement membrane, corneal stroma, and corneal endothelium were investigated by slit-lamp microscopy, ultrasound pachymetry, and light and electron microscopy.

Results : In vivo and in vitro the corneal epithelium was destroyed by freezing, but the epithelial basement membrane remained intact. In vitro, reproducible corneal endothelial damage was achieved using the 3.4 mm-diameter cryoprobe tip with the concave profile. The damage occurred after a short, 3-sec freeze, and was confined to a circular region of the endothelium located directly under the surface application position of the cryoprobe tip. Corneal edema was seen in vivo 24-hrs after freeze injury and was accompanied by alterations to the arrangement of collagen fibrils, but this resolved by 10-days and 1-month concurrent with endothelial repopulation of the wound area.

Conclusions : Surface corneal freezing using a 3.4 mm-diameter concave cryoprobe induces transient stromal edema, but leaves the epithelial basement membrane intact which likely aids epithelial resurfacing. Localized destruction of the endothelial monolayer was achieved in a consistent manner, and represents a potentially useful approach to help treat corneal endothelial dysfunction.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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