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M. Caldwell, A. D. Proia, F. C. DeCroos, N. A. Afshari; A Histological Study of the Interface in Descemet’s Stripping with Endothelial Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2212.
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To study the histopathology of the interface in Descemets stripping with endothelial keratoplasty.
Ten eyes that had undergone penetrating keratoplasty following Descemet’s stripping endothelial keratoplasty were studied retrospectively. Each cornea was trisected and sections were stained with hematoxylin and eosin, periodic acid-Schiff, and colloidal iron. Clinical data were also abstracted from the medical record.
The interface between host and graft in most cases was barely perceptible as slight variations in the degree of tissue eosinophilia or the presence of interface material such as melanin granules or Descemet’s membrane. Alteration in keratocyte density and disruption of the normal lamellar architecture were not appreciated. Residual host Descemet’s membrane was found in eight of the ten cases, most often at the edges of the graft. In no case did the presence of Descemet’s membrane appear to hinder graft adhesion, and in cases of peripheral tissue separation, the Descemet’s membrane was preferentially adherent to the graft as opposed to its native host stroma.
The interface in Descemets stripping with endothelial keratoplasty is not associated with changes in the lamellar architecture or keratocyte density typical of corneal scarring. Contrary to previous assumptions, retained Descemet’s membrane did not appear to hinder graft adhesion.
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