Cleavage plane after liquid‐bubble preparation of Descemet’s membrane

• Published in: Acta ophthalmologica (Oxford, England) Vol. 99; no. 6; pp. e937 - e942
• Main Authors: Rickmann, Annekatrin, Wahl, Silke, Katsen‐Globa, Alisa, Schulz, André, Pütz, Norbert, Szurman, Peter
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.09.2021
• Subjects: Aged; Aged, 80 and over; Collagen; Cornea; Corneal Diseases - surgery; Corneal transplantation; Descemet Membrane - surgery; Descemet Membrane - ultrastructure; Descemet Stripping Endothelial Keratoplasty - methods; Descemet’s membrane endothelial keratoplasty; Dua’s layer; Endothelium, Corneal - transplantation; Female; Humans; Lamellae; liquid‐bubble preparation; Male; Microscopy, Electron, Scanning - methods; Middle Aged; pre‐DM layer; Scanning electron microscopy; Tissue and Organ Harvesting - methods; Tissue Donors; Ultrastructure; Descemet’s membrane endothelial keratoplasty; liquid-bubble preparation; Dua’s layer; pre-DM layer
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.14716

Purpose To investigate the ultrastructure of the cleavage plane of human cornea after liquid‐bubble‐prepared tissue for Descemet’s membrane endothelial keratoplasty (DMEK). Methods Experimental study with scanning electron microscopy (SEM) and block‐face SEM of 18 corneal specimens. Fresh human research donor corneoscleral discs (n = 12) were prepared with liquid‐bubble technique or examined as untreated controls (n = 3). In addition, Descemet’s membrane samples, n = 3, were obtained in DMEK surgery. Results The cleavage plane after liquid‐bubble Descemet’s membrane (DM) preparation was consistently located between interfacial matrix and posterior stromal collagen lamellae, providing a largely smooth surface exposing the amorphous interfacial zone without any significant amounts of adherent stromal remnants. No demarcation of a distinct pre‐DM layer could be detected. Conclusion The DMEK graft preparation performed by liquid‐bubble technique showed a smooth cleavage plane and could not reveal any demarcation of a distinct pre‐DM layer.