Abstract
Purpose: :
To describe the effect of pneumatic dissection of Descement's membrane (DM) on endothelial cell viability and morphology.
Methods: :
18 human corneoscleral rims underwent pneumatic air dissection of DM. Following cleavage the tissue was examined by either vital dye exclusion (n=9) or live/dead cell assay (n=9). Ultrastructural examination of the endothelial cell morphology was performed by electron microscopy (EM). Corneal tissue was also sectioned for histology and TUNEL assay.
Results: :
Air dissection alone was successful in 66% of cases, but with the addition of OVD 100% cleavage was achieved. Histology demonstrated complete clean separation of the DM from overlying stroma. There was no significant loss of endothelial cells by apoptosis on TUNEL assay. Vital dye staining of the endothelial cells showed staining of the nuclei of the cells located at the apex of the bubble. Those located at the base showed no staining. Live dead cell assay show mean percentage cell loss of 10% (SD 5%). EM showed distension of the cellular borders at the apex of the bubble.
Conclusions: :
Pneumatic dissection of DM causes minimal cellular damage and achieves clean dissection of DM. However there is disruption of the intercellular borders at the apex of the bubble which did not affect cell viability.
Keywords: cornea: endothelium