Abstract
Abstract: :
Purpose: It would be advantageous to replace only corneal endothelium for corneal endothelial diseases. In this experiment, we performed continuous circular Descemeto rhexis (CCD) that is a new method to remove only Descemet’s membrane with corneal endothelial cells. We compared histologically the difference between corneas performed by CCD and clinically performed deep lamellar endothelial keratoplasty (DLEK) for deep lamellar dissection. Methods: We used white rabbit eyes in this experiment and performed two different methods for corneal endothelial tissue removal. In one group (deep lamellar dissection group), after filling the anterior chamber with air, through 8.0mm sclerocorneal incision, we made a deep lamellar corneal dissection while checking the air–to–endothelium interface. After dissection, the posterior tissue was trephined (7mm diameter) and trephined endothelial tissue was removed. In another group (Descemeto rhexis group), after filling the anterior chamber with air, through 4.0mm Schlemm’s canal incision, we made a delamination between stroma and Descemet’s membrane by using a dissection blade followed by viscoelastic dissection. 7.0mm diameter of endothelial tissue was removed by CCD with using 27G cystotome. Following endothelial removal, the cornea was removed, cut into sections and stained with hematoxylin and eosin. These sections were observed under light microscopy. Results: In the deep lamellar dissection group, the lamellar structure of collagen fibers were partly broken around the dissection region. In the Descemeto rhexis group, only Descemet’s membrane and endothelial cells were removed. The lamellar structure of collagen fibers in stroma were less disrupted. Conclusions: The techniques of the delamination of Descemet’s membrane and CCD were able to remove corneal endothelial tissue while keeping corneal stromal structure intact. These techniques may have the feasibility to be applicable to corneal endothelial transplantation with less haze than that caused by corneal stromal deep lamellar dissection after transplantation.
Keywords: cornea: endothelium • transplantation • cornea: stroma and keratocytes